Department of Agriculture
Office of Chief Financial Officer
OMB NO: 0505-0001 EXPIRATION DATE: 02/28/2006
RESPS:1,644 HOURS:823 COSTS(000):$0
Advisory Committee and Research and Promotion Board Membership
Background Information
FORMS: AD-755
OMB NO: 0505-0007 EXPIRATION DATE: 09/30/2005
RESPS:7,542 HOURS:7,542 COSTS(000):$0
Debt Collection
FORMS: NONE
OMB NO: 0505-0011 EXPIRATION DATE: 07/31/2003
RESPS:600 HOURS:150 COSTS(000):$0
Maximum Workweek - Construction Schedule
FORMS: NONE
OMB NO: 0505-0013 EXPIRATION DATE: 07/31/2003
RESPS:3,200 HOURS:112,000 COSTS(000):$0
Instructions for the Preparation of Technical and Business
Proposals
FORMS: NONE
OMB NO: 0505-0014 EXPIRATION DATE: 07/31/2003
RESPS:45,170 HOURS:4,517 COSTS(000):$0
Brand Name or Equal Provision and Clause
FORMS: NONE
OMB NO: 0505-0015 EXPIRATION DATE: 07/31/2003
RESPS:200 HOURS:200 COSTS(000):$0
Procurement: Key Personnel Clause
FORMS: NONE
OMB NO: 0505-0016 EXPIRATION DATE: 07/31/2003
RESPS:2,400 HOURS:3,600 COSTS(000):$0
Progress Reporting Clause
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
7 60,756 128,832 $0
Office of Civil Rights
OMB NO: 0508-0004 EXPIRATION DATE: 05/31/2003
RESPS:40,000 HOURS:3,334 COSTS(000):$0
USDA Minority Farm Register
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
1 40,000 3,334 $0
Agricultural Research Service
OMB NO: 0518-0003 EXPIRATION DATE: 11/30/2004
RESPS:75 HOURS:225 COSTS(000):$0
Patent License Application
FORMS: AD-761
OMB NO: 0518-0013 EXPIRATION DATE: 10/31/2005
RESPS:120 HOURS:10 COSTS(000):$0
USDA Biological Shipment Record - Beneficial Organisms
FORMS: 941 942 943
OMB NO: 0518-0024 EXPIRATION DATE: 11/30/2004
RESPS:220 HOURS:53 COSTS(000):$0
Use of facilities or the performance of photography/
cinematography at the U.S. National Arboretum
FORMS: NONE
OMB NO: 0518-0027 EXPIRATION DATE: 02/28/2006
RESPS:3,300 HOURS:725 COSTS(000):$0
Information Collection For Document Delivery Services
FORMS: NONE
OMB NO: 0518-0028 EXPIRATION DATE: 09/30/2003
RESPS:4,360 HOURS:4,601 COSTS(000):$0
Peer Review-Related Forms for the Office of Scientific Quality
Review
FORMS: ARS-199A ARS-200-PA ARS-202PA ARS-203PA ARS-209P ARS-211P
ARS-223P ARS-225P ARS-227P
OMB NO: 0518-0029 EXPIRATION DATE: 08/31/2005
RESPS:200 HOURS:50 COSTS(000):$0
Utilization of Food and Nutrition Information Center (FNIC)
Resources by Personnel at schools receiving USDA funds for Child
Nutrition Programs
FORMS: NONE
OMB NO: 0518-0031 EXPIRATION DATE: 01/31/2005
RESPS:50 HOURS:16 COSTS(000):$0
Food Stamp Nutrition Connection Resource Sharing Form
FORMS: NONE
OMB NO: 0518-0032 EXPIRATION DATE: 02/28/2006
RESPS:11,450 HOURS:572 COSTS(000):$0
Web Order Forms for Research Data, Materials, Models, and
Publications, Speaker Bureau and Conference, Event, and Study
Registration Services.
FORMS: NONE
OMB NO: 0518-0033 EXPIRATION DATE: 02/28/2006
RESPS:100 HOURS:8 COSTS(000):$0
Meeting the Information Requirements of the Animal Welfare Act
Workshop Registration Form
FORMS: NONE
OMB NO: 0518-0034 EXPIRATION DATE: 06/30/2003
RESPS:288 HOURS:48 COSTS(000):$0
Fluoride Content of the US Tap Water Supply
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
10 20,163 6,308 $0
Cooperative State Research, Education, and Extension Service
OMB NO: 0524-0025 EXPIRATION DATE: 10/31/2004
RESPS:960 HOURS:2,472 COSTS(000):$0
Grant Application Forms for the Small Business Innovation
Research Grants Program
FORMS: CSREES-667 CSREES-668
OMB NO: 0524-0026 EXPIRATION DATE: 08/31/2003
RESPS:150 HOURS:600 COSTS(000):$0
Assurance of Compliance with the Department of Agriculture
Regulations Assuring Civil Rights Compliance "Organizational
Information"
FORMS: CSREES-665 CSREES-666
OMB NO: 0524-0034 EXPIRATION DATE: 03/31/2006
RESPS:60 HOURS:30 COSTS(000):$0
Application for Authorization to Use the 4-H Name and/or Emblem
FORMS: CSREES-01
OMB NO: 0524-0038 EXPIRATION DATE: 04/30/2003
RESPS:117 HOURS:457 COSTS(000):$0
Section 1449 Matching Funds Requirement for Research and
Extension Activities at Eligible Institutions
FORMS: CSREES-2103
OMB NO: 0524-0039 EXPIRATION DATE: 03/31/2006
RESPS:59,550 HOURS:156,813 COSTS(000):$0
Cooperative State Research, Education, and Extension Application
Kit for Research and Extension Programs
FORMS: CSREES-2002 CSREES-2003 CSREES-2004 CSREES-2005 CSREES-2006
CSREES-2007 CSREES-2008 CSREES-2010
OMB NO: 0524-0040 EXPIRATION DATE: 02/28/2006
RESPS:75,000 HOURS:12,500 COSTS(000):$0
Questionnaire for Potential Reviewers
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
6 135,837 172,872 $0
National Agricultural Statistical Service
OMB NO: 0535-0001 EXPIRATION DATE: 11/30/2004
RESPS:9,747 HOURS:4,362 COSTS(000):$0
Cold Storage
FORMS: NONE
OMB NO: 0535-0002 EXPIRATION DATE: 12/31/2004
RESPS:436,474 HOURS:122,344 COSTS(000):$0
Field Crops Production
FORMS: NONE
OMB NO: 0535-0003 EXPIRATION DATE: 12/31/2004
RESPS:49,655 HOURS:9,564 COSTS(000):$0
Agricultural Prices
FORMS: NONE
OMB NO: 0535-0004 EXPIRATION DATE: 10/31/2005
RESPS:17,609 HOURS:3,133 COSTS(000):$0
Egg, Chicken, and Turkey Surveys
FORMS: NONE
OMB NO: 0535-0005 EXPIRATION DATE: 07/31/2005
RESPS:52,280 HOURS:12,137 COSTS(000):$0
Livestock Slaughter
FORMS: NONE
OMB NO: 0535-0007 EXPIRATION DATE: 02/28/2006
RESPS:49,132 HOURS:14,580 COSTS(000):$0
Stocks Reports
FORMS: NONE
OMB NO: 0535-0020 EXPIRATION DATE: 09/30/2004
RESPS:177,688 HOURS:24,223 COSTS(000):$0
Milk and Milk Products
FORMS: NONE
OMB NO: 0535-0037 EXPIRATION DATE: 04/30/2003
RESPS:17,896 HOURS:3,071 COSTS(000):$0
Vegetables
FORMS: NONE
OMB NO: 0535-0039 EXPIRATION DATE: 11/30/2004
RESPS:43,782 HOURS:8,794 COSTS(000):$0
Fruit, Nuts and Specialty Crops
FORMS: NONE
OMB NO: 0535-0088 EXPIRATION DATE: 10/31/2005
RESPS:6,795 HOURS:2,696 COSTS(000):$0
Field Crops Objective Yield
FORMS: NONE
OMB NO: 0535-0093 EXPIRATION DATE: 04/30/2003
RESPS:14,600 HOURS:6,532 COSTS(000):$0
Floriculture Survey
FORMS: NONE
OMB NO: 0535-0109 EXPIRATION DATE: 02/28/2006
RESPS:64,570 HOURS:10,859 COSTS(000):$0
Agricultural Labor
FORMS: NONE
OMB NO: 0535-0140 EXPIRATION DATE: 10/31/2003
RESPS:325,000 HOURS:22,500 COSTS(000):$0
List Sampling Frame Survey
FORMS: NONE
OMB NO: 0535-0150 EXPIRATION DATE: 04/30/2003
RESPS:3,300 HOURS:861 COSTS(000):$0
Acquaculture Survey
FORMS: NONE
OMB NO: 0535-0153 EXPIRATION DATE: 09/30/2003
RESPS:7,278 HOURS:2,492 COSTS(000):$0
Honey Survey
FORMS: NONE
OMB NO: 0535-0209 EXPIRATION DATE: 02/29/2004
RESPS:50 HOURS:150 COSTS(000):$0
Supplemental Qualifications Statement
FORMS: NONE
OMB NO: 0535-0212 EXPIRATION DATE: 06/30/2005
RESPS:359 HOURS:58 COSTS(000):$0
Mink Survey
FORMS: NONE
OMB NO: 0535-0213 EXPIRATION DATE: 01/31/2004
RESPS:526,955 HOURS:143,472 COSTS(000):$0
Agricultural Surveys Program
FORMS: NONE
OMB NO: 0535-0217 EXPIRATION DATE: 02/28/2005
RESPS:21,000 HOURS:1,700 COSTS(000):$0
Wildlife Damage Survey
FORMS: NONE
OMB NO: 0535-0218 EXPIRATION DATE: 12/31/2003
RESPS:65,775 HOURS:24,093 COSTS(000):$0
Agricultural Resource Management, Chemical Use, and Post-harvest
Chemical Use Surveys
FORMS: NONE
OMB NO: 0535-0220 EXPIRATION DATE: 03/31/2004
RESPS:10,417 HOURS:1,065 COSTS(000):$0
Cotton Ginnings
FORMS: NONE
OMB NO: 0535-0226 EXPIRATION DATE: 10/31/2004
RESPS:2,358,026 HOURS:1,354,204 COSTS(000):$0
2002 Census of Agriculture
FORMS: 02-A0101 02-A0114 02-A01 02-A0201 02-A0215 02-A02(I) 02-A04
02-A04(L1) 02-A1(CMNI) 02-A1(PR)
OMB NO: 0535-0235 EXPIRATION DATE: 04/30/2005
RESPS:46,450 HOURS:10,635 COSTS(000):$0
Childhood Injury and Adult Occupational Injury Survey
FORMS: NONE
OMB NO: 0535-0241 EXPIRATION DATE: 10/31/2003
RESPS:21,720 HOURS:3,658 COSTS(000):$0
Monthly Hog Survey
FORMS: NONE
OMB NO: 0535-0244 EXPIRATION DATE: 01/31/2004
RESPS:4,874 HOURS:3,229 COSTS(000):$0
Nursery and Greenhouse Production Survey and Nursery and
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
25 4,331,432 1,790,412 $0
Economic Research Service
OMB NO: 0536-0043 EXPIRATION DATE: 09/30/2005
RESPS:57,000 HOURS:7,126 COSTS(000):$0
Food Security Supplement to the Current Population Survey
FORMS: NONE
OMB NO: 0536-0052 EXPIRATION DATE: 03/31/2004
RESPS:1,312 HOURS:729 COSTS(000):$0
The Use of Food Safety Practices in Meat and Poultry
FORMS: NONE
OMB NO: 0536-0053 EXPIRATION DATE: 11/30/2003
RESPS:37,278 HOURS:5,110 COSTS(000):$0
Study of Program Access and Declining Food Stamp Participation
FORMS: NONE
OMB NO: 0536-0055 EXPIRATION DATE: 02/29/2004
RESPS:2,052 HOURS:817 COSTS(000):$0
Assesment of WIC Cost-Containment Practices
FORMS: NONE
OMB NO: 0536-0056 EXPIRATION DATE: 05/31/2004
RESPS:424 HOURS:3,400 COSTS(000):$0
Summer Food Service Program Implementation Study
FORMS: NONE
OMB NO: 0536-0057 EXPIRATION DATE: 08/31/2004
RESPS:4,870 HOURS:1,212 COSTS(000):$0
Emergency Food Assistance System Client Survey
FORMS: NONE
OMB NO: 0536-0058 EXPIRATION DATE: 09/30/2004
RESPS:53 HOURS:1,244 COSTS(000):$0
CACFP Administrative Cost Reimbursement Study
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
7 102,989 19,638 $0
Foreign Agricultural Service
OMB NO: 0551-0001 EXPIRATION DATE: 12/31/2003
RESPS:440 HOURS:270 COSTS(000):$0
Title Dairy Tariff-Rate Import Quota Licensing Regulation
FORMS: 923 923A 923B 924A 924B
OMB NO: 0551-0004 EXPIRATION DATE: 02/28/2006
RESPS:22,758 HOURS:11,415 COSTS(000):$0
CCC's Export Credit Guarantee Program (GSM-102), Intermediate
Credit Guarantee Program (GSM-103) Supplier Credit Guarantee
Program (SCGP)
FORMS: NONE
OMB NO: 0551-0005 EXPIRATION DATE: 08/31/2003
RESPS:205 HOURS:423 COSTS(000):$0
Regulations - Financing Commercial Sales of Agricultural
Commodities Under Title I, P.L. 480 - Recordkeeping and
Reporting Requirements
FORMS: NONE
OMB NO: 0551-0007 EXPIRATION DATE: 07/31/2004
RESPS:50,260 HOURS:24,523 COSTS(000):$0
Export Sales of U.S. Agricultural Commodities
FORMS: FAS-97 FAS-98 FAS-99 FAS-100
OMB NO: 0551-0008 EXPIRATION DATE: 06/30/2005
RESPS:36 HOURS:9 COSTS(000):$0
Request for Vessel Approval
FORMS: CCC-105
OMB NO: 0551-0009 EXPIRATION DATE: 08/31/2003
RESPS:89 HOURS:23 COSTS(000):$0
Declaration of Sale
FORMS: FAS-359
OMB NO: 0551-0014 EXPIRATION DATE: 02/29/2004
RESPS:1,200 HOURS:200 COSTS(000):$0
Certificate for Quota Eligibility
FORMS: FAS-961
OMB NO: 0551-0015 EXPIRATION DATE: 12/31/2004
RESPS:977 HOURS:4,377 COSTS(000):$0
Sugar imported to be re-exported in refined form, in sugar-
containing products, or used in production of certain polyhydric
alcohols.
FORMS: NONE
OMB NO: 0551-0024 EXPIRATION DATE: 06/30/2003
RESPS:1,800 HOURS:1,010 COSTS(000):$0
Buyer Alert
FORMS: FAS-964
OMB NO: 0551-0025 EXPIRATION DATE: 02/28/2005
RESPS:20 HOURS:40 COSTS(000):$0
Specialty Sugar Certificates
FORMS: NONE
OMB NO: 0551-0026 EXPIRATION DATE: 04/30/2003
RESPS:2,134 HOURS:43,748 COSTS(000):$0
FAS/Cooperator Foreign Market Development Program
FORMS: NONE
OMB NO: 0551-0027 EXPIRATION DATE: 06/30/2003
RESPS:2,670 HOURS:62,830 COSTS(000):$0
Market Access Program
FORMS: NONE
OMB NO: 0551-0028 EXPIRATION DATE: 09/30/2003
RESPS:3,063 HOURS:1,803 COSTS(000):$0
CCC's Export Enhancement Program (EEP) and CCC's Export
Incentive Program (DEIP)
FORMS: NONE
OMB NO: 0551-0032 EXPIRATION DATE: 04/30/2004
RESPS:66 HOURS:256 COSTS(000):$2,000
CCC's Facility Guarantee Program (FGP)
FORMS: NONE
OMB NO: 0551-0033 EXPIRATION DATE: 12/31/2005
RESPS:2 HOURS:46 COSTS(000):$0
Emergency Relief from Duty-Free Imports of Perishable Products
under the Andean Trade Promotion and Drug Eradication Act
(ATPDEA)
FORMS: NONE
OMB NO: 0551-0035 EXPIRATION DATE: 02/29/2004
RESPS:3,510 HOURS:38,827 COSTS(000):$0
Foreign Donation of Agricultural Commodities
FORMS: NONE
OMB NO: 0551-0037 EXPIRATION DATE: 02/29/2004
RESPS:2,495 HOURS:1,166 COSTS(000):$0
CCC's Supplier Credit Guarantee Program (SCGP)
FORMS: NONE
OMB NO: 0551-0038 EXPIRATION DATE: 04/30/2003
RESPS:100 HOURS:640 COSTS(000):$0
Technical Assisstance for Specialty Crops
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
18 91,825 191,606 $2,000
Farm Service Agency
OMB NO: 0560-0025 EXPIRATION DATE: 04/30/2003
RESPS:112,820 HOURS:197,435 COSTS(000):$0
Farm Reconstitution -- 7 CFR Part 718
FORMS: FSA-155
OMB NO: 0560-0026 EXPIRATION DATE: 09/30/2004
RESPS:4,000 HOURS:6,000 COSTS(000):$0
Application for payment of amounts due persons who have died,
disappeared or have been declared incompetent.
FORMS: FSA-325
OMB NO: 0560-0040 EXPIRATION DATE: 01/31/2004
RESPS:13,401 HOURS:25,946 COSTS(000):$0
Regulations for Cooperative Marketing Associations, 7 CFR Part
1425
FORMS: CCC-719 726 727 732 734 736 846 846-1 COTTON-G COTTON-G4
OMB NO: 0560-0052 EXPIRATION DATE: 10/31/2003
RESPS:9,680 HOURS:484,410 COSTS(000):$0
Standards for Approval of Waraehouses-7 CFR 1421, 1423, and 1427
FORMS: CCC-25 25ADDEN.1 25-1(SUPP)/29-1 25-2/29 823-1A/823-1T
29-3/20/24/560 49/24-1/29/ 29ADDEN.1/823 33/33-A/34/34-1
KC-14/40/227
OMB NO: 0560-0058 EXPIRATION DATE: 09/30/2004
RESPS:1,403,207 HOURS:1,501,734 COSTS(000):$0
Tobacco Marketing Quotas and Price Support (7 CFR Parts 711,
723, and 1464).
FORMS: MQ-25 MQ-32 MQ-38 MQ-38BUR MQ-53 MQ-71 MQ-72-2 MQ-76 MQ-77
OMB NO: 0560-0074 EXPIRATION DATE: 01/31/2005
RESPS:96,122 HOURS:45,246 COSTS(000):$0
7 CFR 1427-Regulations Governing CCC Nonrecourse Cotton Loan
Programs for 1996 and Subsequent Crops
FORMS: CCC-COTTON-A CCC-COTTON-A-1 CCC-COTTON-A-5 CCC-605 CCC-605-1
CCC-605-2 CCC-809 CCC-810 CCC-877 CCC-879
OMB NO: 0560-0082 EXPIRATION DATE: 10/31/2005
RESPS:251,000 HOURS:187,667 COSTS(000):$0
7 CFR Part 701 - Conservation and Environmental Programs
FORMS: AD-245 FSA-18
OMB NO: 0560-0087 EXPIRATION DATE: 03/31/2005
RESPS:1,858,515 HOURS:552,324 COSTS(000):$0
General Regulations Governing Commodity Loans for 1996 and
Subsequent Crops
FORMS: CCC-64/CCC-601 CCC-638/CCC-665 CCC-666/CCC-677 CCC-679/CCC-685
CCC-699 CCC-681-A CCC-681-1 CCC-678 CCC-6811 CCC-156
OMB NO: 0560-0092 EXPIRATION DATE: 09/30/2004
RESPS:2,131,523 HOURS:2,664,404 COSTS(000):$0
Forms for Participation in a 7-year Production Flexibility
Contract
FORMS: CCC-478 CCC-478B CCC-505
OMB NO: 0560-0096 EXPIRATION DATE: 06/30/2003
RESPS:351,960 HOURS:626,727 COSTS(000):$0
Payment Limitation and Determination of Eligibility of Foreign
Individuals or Entities to Receive Program Benefits
FORMS: CCC-501A CCC-501B CCC-502A CCC-502B CCC-502C CCC-502D CCC-502EZ
CCC-502CONTINUA TION
OMB NO: 0560-0097 EXPIRATION DATE: 10/31/2003
RESPS:4,375 HOURS:1,108 COSTS(000):$0
Agricultural Foreign Investment Disclosure Act Report
FORMS: FSA-153
OMB NO: 0560-0120 EXPIRATION DATE: 08/31/2005
RESPS:25,265 HOURS:10,452 COSTS(000):$0
Warehouse Regulations Under USWA and As applicable Standards for
Approval of Warehouses
FORMS: WA-50/WA-51-2 WA-53/WA-70 WA-80/WA-81 WA-82/WA-83 WA/84/WA-85
WA-86/WA-87 WA-88/WA-105 WA-125/WA-139 WA-140/WA-141 WA-141-1
OMB NO: 0560-0129 EXPIRATION DATE: 03/31/2004
RESPS:6,105,000 HOURS:3,825,000 COSTS(000):$0
Loan Deficiency Payments
FORMS: CCC-633-LDP CCC-709
OMB NO: 0560-0138 EXPIRATION DATE: 10/31/2004
RESPS:1,381 HOURS:18,429 COSTS(000):$0
Sugar Program
FORMS: CCC-80 CCC-831 CCC-832 CCC-833 CCC-835 CCC-836 CCC-837 CCC-838
OMB NO: 0560-0146 EXPIRATION DATE: 03/31/2006
RESPS:250 HOURS:125 COSTS(000):$0
Debt Settlement Policies and Procedures
FORMS: CCC-279
OMB NO: 0560-0151 EXPIRATION DATE: 06/30/2003
RESPS:25,927 HOURS:4,520 COSTS(000):$0
End-Use Certificate Program
FORMS: FSA-750 FSA-751
OMB NO: 0560-0154 EXPIRATION DATE: 09/30/2004
RESPS:74,225 HOURS:159,562 COSTS(000):$0
7 CFR 1924 B Management Advice To Individuals Borrowers and
Applicants
FORMS: FSA-431-2 FSA-1924-22 FSA-1924-23 FSA-1924-24 FSA-1924-27
OMB NO: 0560-0155 EXPIRATION DATE: 03/31/2004
RESPS:293,676 HOURS:228,074 COSTS(000):$0
Guaranteed Farm Loans
FORMS: FSA-1980-25 1980-28 1980-64 1980-24 1980-15 1980-22 1980-38
1980-19 1980-41 1980-43
OMB NO: 0560-0157 EXPIRATION DATE: 01/31/2004
RESPS:312 HOURS:63 COSTS(000):$0
Insured Farm Ownership Loan Policies, Procedures, and
Authorizations
FORMS: FSA-440-35
OMB NO: 0560-0158 EXPIRATION DATE: 07/31/2005
RESPS:14,080 HOURS:6,753 COSTS(000):$0
7 CFR 1965-A, Servicing of Real Estate Security for Farmer
Program Loans and Certain Note-Only Cases
FORMS: RD-465-1 RD-443-16 FSA-440-26 FMHA-440-9 FMHA-1965-11
FMHA-1965-13 RD-465-5
OMB NO: 0560-0159 EXPIRATION DATE: 01/31/2004
RESPS:16,938 HOURS:14,223 COSTS(000):$0
7 CFR 1945-D, Emergency Loan Policies, Procedures and
Authorizations
FORMS: 1945-22 1940-38
OMB NO: 0560-0160 EXPIRATION DATE: 03/31/2005
RESPS:200 HOURS:800 COSTS(000):$0
7 CFR 1951-L, Servicing Cases Where Unauthorized Loan or Other
Assistance was Received
FORMS: NONE
OMB NO: 0560-0161 EXPIRATION DATE: 03/31/2004
RESPS:26,963 HOURS:13,109 COSTS(000):$0
Farm Loan Programs Account Servicing Policies
FORMS: FSA-1951-39
OMB NO: 0560-0162 EXPIRATION DATE: 02/29/2004
RESPS:51,466 HOURS:6,176 COSTS(000):$0
7 CFR 1941-A, Operating Loan Policies, Procedures and
Authorizations
FORMS: 1940-51 1940-53 1940-55 2940-56 441-8 441-18 441-25 441-10
441-13
OMB NO: 0560-0164 EXPIRATION DATE: 04/30/2003
RESPS:21,629 HOURS:12,233 COSTS(000):$0
Disaster Set-Aside Program -- 7 CFR 1951 Subpart T
FORMS: NONE
OMB NO: 0560-0165 EXPIRATION DATE: 02/29/2004
RESPS:125 HOURS:775 COSTS(000):$0
Certified Mediation Program
FORMS: NONE
OMB NO: 0560-0166 EXPIRATION DATE: 06/30/2005
RESPS:48,312 HOURS:12,078 COSTS(000):$0
Verification of Debts and Assets
FORMS: FSA-440-32
OMB NO: 0560-0167 EXPIRATION DATE: 02/28/2006
RESPS:48,321 HOURS:96,642 COSTS(000):$0
Request for Direct Loan Assistance
FORMS: FSA-410-1
OMB NO: 0560-0170 EXPIRATION DATE: 06/30/2003
RESPS:2,236 HOURS:988 COSTS(000):$0
Disaster Assistance - General (7 CFR Part 1945-A)
FORMS: NONE
OMB NO: 0560-0171 EXPIRATION DATE: 03/31/2005
RESPS:83,050 HOURS:20,531 COSTS(000):$0
Agreement for the Use of Proceeds/Release of Chattel Security
FORMS: 1962-1
OMB NO: 0560-0175 EXPIRATION DATE: 09/30/2003
RESPS:3,564,000 HOURS:4,618,346 COSTS(000):$0
Noninsured Crop Disaster Assistance Program
FORMS: CCC-451 CCC-576 CCC-441 CCC-576-1 CCC-452
OMB NO: 0560-0176 EXPIRATION DATE: 03/31/2005
RESPS:24,000 HOURS:8,000 COSTS(000):$0
Request for Aerial Photography
FORMS: FSA-441
OMB NO: 0560-0177 EXPIRATION DATE: 09/30/2005
RESPS:37,763 HOURS:6,758 COSTS(000):$0
Offer Forms
FORMS: 156 269 327 324 366 332 331 334 337 333
OMB NO: 0560-0178 EXPIRATION DATE: 10/31/2004
RESPS:75,489 HOURS:122,538 COSTS(000):$0
7 CFR 1910-A, Receiving and Processing Applications
FORMS: NONE
OMB NO: 0560-0179 EXPIRATION DATE: 02/28/2005
RESPS:3,000 HOURS:5,000 COSTS(000):$0
Certification of Livestock Losses for Eligible Disaster
FORMS: CCC-661
OMB NO: 0560-0185 EXPIRATION DATE: 06/30/2003
RESPS:206,250 HOURS:251,153 COSTS(000):$0
Highly Erodible Land Conservation and Wetland Conservation (7
CFR Part 12)
FORMS: AD-1026 AD-1026B AD-1026C AD-1026D AD-1068 AD-1069 CCC-21
FSA-492
OMB NO: 0560-0194 EXPIRATION DATE: 10/31/2005
RESPS:14 HOURS:14 COSTS(000):$0
Standard Operating Agreement Governing Intermodal Transportation
FORMS: NONE
OMB NO: 0560-0195 EXPIRATION DATE: 10/31/2005
RESPS:99 HOURS:99 COSTS(000):$0
Standard Rules Tender Governing Motor Carrier Transportation
FORMS: NONE
OMB NO: 0560-0201 EXPIRATION DATE: 01/31/2004
RESPS:1,860 HOURS:930 COSTS(000):$0
ELS Cotton Competitiveness Payment Program
FORMS: CCC-1045-A CCC-1045A-2
OMB NO: 0560-0203 EXPIRATION DATE: 02/29/2004
RESPS:1,039,306 HOURS:20,786 COSTS(000):$0
Facsimile Signature Authorization and Verification
FORMS: FSA-237
OMB NO: 0560-0204 EXPIRATION DATE: 01/31/2004
RESPS:280,000 HOURS:90,600 COSTS(000):$0
Farm Storage Facility Loan Program
FORMS: CCC-185 CCC-186 CCC-186-1 CCC-190 CCC-191 CCC-193 CCC-194
CCC-296 CCC-297 CCC-298
OMB NO: 0560-0207 EXPIRATION DATE: 11/30/2003
RESPS:1,100 HOURS:1,286 COSTS(000):$0
Bioenergy Program (7 CFR Part 1424)
FORMS: CCC-850-A SF-LLL SF-3881 ATF-F-5110.74 ATF-F-5110.75
ATF-F-5110.41
OMB NO: 0560-0214 EXPIRATION DATE: 10/31/2004
RESPS:1,000 HOURS:250 COSTS(000):$15,000
Total Quality Systems Audit
FORMS: 1TQ 3TQ
OMB NO: 0560-0215 EXPIRATION DATE: 09/30/2005
RESPS:207,500 HOURS:120,350 COSTS(000):$0
Representations for CCC and FSA Loans and Authorization to File
a Financing Statement
FORMS: CCC-10
OMB NO: 0560-0216 EXPIRATION DATE: 09/30/2005
RESPS:836 HOURS:2,539 COSTS(000):$0
Storage of Honey Forfeited to CCC by Honey Producers
FORMS: CCC-56 56-1 56-2 55
OMB NO: 0560-0219 EXPIRATION DATE: 10/31/2005
RESPS:1,100,000 HOURS:1,331,000 COSTS(000):$0
USDA Registration Formto Request Electronic Access Code
FORMS: AD-2016
OMB NO: 0560-0221 EXPIRATION DATE: 04/30/2003
RESPS:2,000 HOURS:1,258 COSTS(000):$0
Horse Breeder Loan Program
FORMS: 410-1 431-2 440-32 1910-5 1940-38 1927-9 1927-10
OMB NO: 0560-0224 EXPIRATION DATE: 02/28/2006
RESPS:113 HOURS:113 COSTS(000):$0
Brokerage Agreement for the Transportation of USDA Commodities
FORMS: NONE
OMB NO: 0560-0227 EXPIRATION DATE: 09/30/2003
RESPS:2,860 HOURS:321 COSTS(000):$0
National Nonprofit Humanitarian Program 501(3)(3)
FORMS: CCC-330 CCC-330A
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
49 19,623,149 17,304,875 $15,000
Federal Crop Insurance Corporation
OMB NO: 0563-0053 EXPIRATION DATE: 02/28/2005
RESPS:3,345,415 HOURS:1,194,316 COSTS(000):$67,750
Multiple Peril Crop Insurance
FORMS: NONE
OMB NO: 0563-0055 EXPIRATION DATE: 03/31/2006
RESPS:156 HOURS:78 COSTS(000):$0
General Administrative Regulations; Interpretations of Statutory
and Regulatory Provisions
FORMS: NONE
OMB NO: 0563-0057 EXPIRATION DATE: 04/30/2003
RESPS:14,880 HOURS:5,394 COSTS(000):$0
New-Crop Insurance Programs (Pilot and Private Crop Insurance
FORMS: NONE
OMB NO: 0563-0058 EXPIRATION DATE: 08/31/2004
RESPS:30,970 HOURS:37,257 COSTS(000):$0
Dairy Options Pilot Program (DOPP), Round III
FORMS: CCC-320 CCC-320-1 CCC-321 CCC-322 CCC-323
OMB NO: 0563-0060 EXPIRATION DATE: 02/28/2005
RESPS:55,760 HOURS:32,526 COSTS(000):$0
Specialty Crop Producer Survey
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
5 3,447,181 1,269,571 $67,750
Rural Business-Cooperative Service
OMB NO: 0570-0006 EXPIRATION DATE: 11/30/2003
RESPS:775 HOURS:1,848 COSTS(000):$0
7 CFR 4284-F, Rural Cooperative Development Grant
FORMS: NONE
OMB NO: 0570-0007 EXPIRATION DATE: 04/30/2004
RESPS:2,649 HOURS:2,404 COSTS(000):$0
Annual Survey of Farmer Cooperatives
FORMS: NONE
OMB NO: 0570-0012 EXPIRATION DATE: 06/30/2003
RESPS:2,276 HOURS:7,742 COSTS(000):$0
Rural Economic Development Loan and Grant Program
FORMS: RD-1703-1
OMB NO: 0570-0014 EXPIRATION DATE: 06/30/2005
RESPS:1 HOURS:1 COSTS(000):$0
7 CFR 1980-E, Business and Industrial Loan Program
FORMS: RD-449-1 RD-449-2
OMB NO: 0570-0015 EXPIRATION DATE: 06/30/2005
RESPS:4,185 HOURS:11,235 COSTS(000):$0
7 CFR 1951-R-Rural Development Loan Servicing
FORMS: RD-1951-4
OMB NO: 0570-0016 EXPIRATION DATE: 04/30/2003
RESPS:19,548 HOURS:10,019 COSTS(000):$0
Servicing Business and Industry Guaranteed Loans -- 7 CFR 4287-B
FORMS: RD-1980-41 RD-1980-44
OMB NO: 0570-0017 EXPIRATION DATE: 04/30/2003
RESPS:8,875 HOURS:20,813 COSTS(000):$0
Guaranteed Loanmaking; Business and Industry Loans -- 7 CFR
4279-B
FORMS: RD-4279-1 RD-4279-2 RD-4279-3 RD-4279-4 RD-4279-6
OMB NO: 0570-0018 EXPIRATION DATE: 04/30/2003
RESPS:1,147 HOURS:1,749 COSTS(000):$0
Business and Industry Guaranteed Loanmaking (General) -- 7 CFR
4279-A
FORMS: RD-4279-8
OMB NO: 0570-0020 EXPIRATION DATE: 02/28/2005
RESPS:127 HOURS:127 COSTS(000):$0
Annual Survey of Cooperative Involvement in International Markets
FORMS: NONE
OMB NO: 0570-0021 EXPIRATION DATE: 09/30/2003
RESPS:3,802 HOURS:16,930 COSTS(000):$0
Intermediary Relending Program
FORMS: RD-4274-1 4274-3 4274-4 4274-5
OMB NO: 0570-0022 EXPIRATION DATE: 10/31/2003
RESPS:21,172 HOURS:38,334 COSTS(000):$0
7 CFR 1942-G "Rural Business Enterprise Grants and Television
Demonstration Grants"
FORMS: NONE
OMB NO: 0570-0024 EXPIRATION DATE: 06/30/2004
RESPS:866 HOURS:8,044 COSTS(000):$0
CFR Part 4284-G, Rural Business Opportunity Grants
FORMS: NONE
OMB NO: 0570-0027 EXPIRATION DATE: 04/30/2003
RESPS:8 HOURS:1,382 COSTS(000):$0
Rural Empowerment Zones and Enterprise Communities
FORMS: NONE
OMB NO: 0570-0028 EXPIRATION DATE: 02/29/2004
RESPS:240 HOURS:1,140 COSTS(000):$0
Research on Rural Cooperative Opportunities and Problems
FORMS: NONE
OMB NO: 0570-0039 EXPIRATION DATE: 10/31/2004
RESPS:1,596 HOURS:19,452 COSTS(000):$0
Value-Added Agricultural Product Market Development Grant
Program (Independent Producers)
FORMS: NONE
OMB NO: 0570-0040 EXPIRATION DATE: 06/30/2005
RESPS:48 HOURS:628 COSTS(000):$0
Agricultural Product Market Development Grant Program (Resource
Center)
FORMS: NONE
OMB NO: 0570-0041 EXPIRATION DATE: 03/31/2006
RESPS:297 HOURS:762 COSTS(000):$0
1890 Land Grant Institutions: Rural Entrepreneurial Program
Outreach Initiative
FORMS: NONE
OMB NO: 0570-0042 EXPIRATION DATE: 02/29/2004
RESPS:490 HOURS:113 COSTS(000):$0
Survey of Cooperatives on Selecting Director Candidates for
Director Elections
FORMS: NONE
OMB NO: 0570-0043 EXPIRATION DATE: 04/30/2003
RESPS:50 HOURS:300 COSTS(000):$0
National Rural Development Partnership
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
19 68,152 143,023 $0
Rural Utilities Service
OMB NO: 0572-0003 EXPIRATION DATE: 10/31/2005
RESPS:1,422 HOURS:38,394 COSTS(000):$0
Accounting Requirements for RUS Electric and Telecommunications
Borrowers
FORMS: NONE
OMB NO: 0572-0015 EXPIRATION DATE: 03/31/2006
RESPS:10,020 HOURS:14,820 COSTS(000):$0
Advance of Loan Funds and Budgetary Control and Other Related
Burdens
FORMS: RUS-219 RUS-595
OMB NO: 0572-0019 EXPIRATION DATE: 06/30/2003
RESPS:6,750 HOURS:10,125 COSTS(000):$0
Inventory of Work Orders
FORMS: RUS-FORM-219
OMB NO: 0572-0020 EXPIRATION DATE: 04/30/2003
RESPS:5 HOURS:15 COSTS(000):$0
Request for Approval to Sell Capital Assets
FORMS: 369
OMB NO: 0572-0023 EXPIRATION DATE: 05/31/2003
RESPS:3,680 HOURS:3,660 COSTS(000):$0
7 CFR 1744-C, Advance and Disbursement of Funds -
Telecommunications
FORMS: RUS-FORM-481
OMB NO: 0572-0025 EXPIRATION DATE: 04/30/2003
RESPS:253 HOURS:1,012 COSTS(000):$0
Review Rating Summary
FORMS: 300
OMB NO: 0572-0031 EXPIRATION DATE: 04/30/2003
RESPS:1 HOURS:3,200 COSTS(000):$0
Financial and Statistical Report for Telecommunications Borrowers
FORMS: RUS-FORM-479
OMB NO: 0572-0032 EXPIRATION DATE: 02/28/2005
RESPS:4,415 HOURS:65,673 COSTS(000):$0
RUS Electric Loan Application and Related Reporting Burdens
FORMS: RUS-726 RUS-740C RUS-740G 7 12 325 266 SF-100 SF-LLL AD-1047
OMB NO: 0572-0041 EXPIRATION DATE: 08/31/2003
RESPS:75 HOURS:206 COSTS(000):$0
Request for Release of Lien and/or Approval of Sale
FORMS: RUS-FORM-793
OMB NO: 0572-0051 EXPIRATION DATE: 09/30/2005
RESPS:905 HOURS:226 COSTS(000):$0
RUS Form 87, Request for Mail List Data
FORMS: FORM-87
OMB NO: 0572-0074 EXPIRATION DATE: 06/30/2003
RESPS:665 HOURS:67 COSTS(000):$0
Certification of Authority
FORMS: RUS-FORM-675
OMB NO: 0572-0079 EXPIRATION DATE: 09/30/2003
RESPS:406 HOURS:3,621 COSTS(000):$0
Preloan Procedures and Requirements for Telecommunications
Program
FORMS: FORM-490 494 495 507 567 569
OMB NO: 0572-0088 EXPIRATION DATE: 08/31/2003
RESPS:30 HOURS:62 COSTS(000):$0
7 CFR Part 1786, "Prepayment of RUS Guaranteed and Insured Loans
to Electric and Telephone Borrowers"
FORMS: NONE
OMB NO: 0572-0089 EXPIRATION DATE: 01/31/2004
RESPS:110 HOURS:660 COSTS(000):$0
RUS Form 444, "Wholesale Power Contracts"
FORMS: RUS-FORM-444
OMB NO: 0572-0095 EXPIRATION DATE: 04/30/2003
RESPS:3,872 HOURS:20,374 COSTS(000):$0
7 CFR 1773, Policy on Audits of RUS Borrowers
FORMS: NONE
OMB NO: 0572-0096 EXPIRATION DATE: 08/31/2003
RESPS:6,900 HOURS:17,741 COSTS(000):$0
Distance Learning and Telemedicine Loan and Grant Program (7 CFR
1703, Subpart D, E, F and G)
FORMS: NONE
OMB NO: 0572-0097 EXPIRATION DATE: 05/31/2003
RESPS:40 HOURS:140 COSTS(000):$0
7 CFR Part 1703-H, Deferments of RUS Loan Payments for Rural
Development Projects
FORMS: NONE
OMB NO: 0572-0098 EXPIRATION DATE: 04/30/2003
RESPS:25 HOURS:238 COSTS(000):$0
7 CFR 1744-E, Borrower Investments-Telecommunications Loan
Program
FORMS: NONE
OMB NO: 0572-0099 EXPIRATION DATE: 10/31/2003
RESPS:1,000 HOURS:750 COSTS(000):$0
7 CFR 1792, Subpart C - Seismic Safety of New Building
Construction
FORMS: NONE
OMB NO: 0572-0100 EXPIRATION DATE: 04/30/2003
RESPS:42 HOURS:69 COSTS(000):$0
Lien Accommodations and Subordinations 7 CFR Part 1717, Subparts
R and S
FORMS: NONE
OMB NO: 0572-0104 EXPIRATION DATE: 08/31/2003
RESPS:1 HOURS:350 COSTS(000):$0
State Telecommunications Modernization Plan
FORMS: NONE
OMB NO: 0572-0107 EXPIRATION DATE: 10/31/2005
RESPS:3,908 HOURS:85 COSTS(000):$0
7 CFR 1726, Electric System Construction Policies and
Procedures- Electric
FORMS: 168B/168C/187 198/200/213 224/231/238 254/257/307 786/790/792B
830
OMB NO: 0572-0109 EXPIRATION DATE: 09/30/2004
RESPS:1 HOURS:9 COSTS(000):$0
7 CFR 1777, Section 306C Water and Waste Disposal (WWD) Loans &
Grants
FORMS: NONE
OMB NO: 0572-0112 EXPIRATION DATE: 05/31/2003
RESPS:1,375 HOURS:4,168 COSTS(000):$0
7 CFR 1775, Technical Assistance Program
FORMS: NONE
OMB NO: 0572-0114 EXPIRATION DATE: 04/30/2003
RESPS:142 HOURS:184 COSTS(000):$0
Mergers and Consolidations of Electric Borrowers -- 7 CFR 1717
Subpart D
FORMS: NONE
OMB NO: 0572-0115 EXPIRATION DATE: 04/30/2003
RESPS:6 HOURS:12 COSTS(000):$0
Use of Consultants Funded by Borrowers -- 7 CFR Part 1789
FORMS: NONE
OMB NO: 0572-0116 EXPIRATION DATE: 06/30/2003
RESPS:1 HOURS:3,000 COSTS(000):$0
7 CFR 1717 Subpart Y, Settlement of Debt Owed by Electric
Borrowers
FORMS: NONE
OMB NO: 0572-0117 EXPIRATION DATE: 03/31/2004
RESPS:1,872 HOURS:450,200 COSTS(000):$0
Environmental Policies and Procedures (7 CFR Part 1794)
FORMS: NONE
OMB NO: 0572-0118 EXPIRATION DATE: 03/31/2006
RESPS:161 HOURS:161 COSTS(000):$0
7 CFR Part 1724, Electric Engineering Architectural Services and
Design Policies and Procedures
FORMS: 211 220 236
OMB NO: 0572-0121 EXPIRATION DATE: 06/30/2003
RESPS:50,650 HOURS:134,240 COSTS(000):$0
7 CFR 1780, Water and Waste Disposal Loan and Grant Program
FORMS: NONE
OMB NO: 0572-0122 EXPIRATION DATE: 01/31/2004
RESPS:110 HOURS:858 COSTS(000):$0
Water and Waste Disposal Programs Guaranteed Loans
FORMS: NONE
OMB NO: 0572-0123 EXPIRATION DATE: 12/31/2004
RESPS:180 HOURS:784 COSTS(000):$0
Extensions of Payments of Principal and Interest
FORMS: NONE
OMB NO: 0572-0124 EXPIRATION DATE: 09/30/2004
RESPS:120 HOURS:345 COSTS(000):$0
Weather Radio Transmitter Grant Program
FORMS: NONE
OMB NO: 0572-0125 EXPIRATION DATE: 06/30/2005
RESPS:30 HOURS:1,005 COSTS(000):$0
Local Dial-Up Internet Grant Program
FORMS: NONE
OMB NO: 0572-0126 EXPIRATION DATE: 01/31/2005
RESPS:45 HOURS:23 COSTS(000):$0
7 CFR Part 1744, Subpart B, Lien Accommodations and
Subordination Policy
FORMS: NONE
OMB NO: 0572-0127 EXPIRATION DATE: 03/31/2004
RESPS:310 HOURS:48,010 COSTS(000):$0
Broadband Pilot Grant Program
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
36 99,528 824,487 $0
Rural Housing Service
OMB NO: 0575-0015 EXPIRATION DATE: 06/30/2003
RESPS:33,230 HOURS:61,076 COSTS(000):$0
7 CFR 1942-A, Community Facility Loans
FORMS: 442-7 442-3 1942-19 1942-8 1942-46 1942-47 1942-9 442-20 442-21
442-22
OMB NO: 0575-0018 EXPIRATION DATE: 04/30/2005
RESPS:74,516 HOURS:555,692 COSTS(000):$0
7 CFR 1901-3, Civil Rights Compliance Requirements
FORMS: RD-4001/4/6/7/8 HUD-932.5 CC-257
OMB NO: 0575-0033 EXPIRATION DATE: 10/31/2004
RESPS:2,382,265 HOURS:2,143,740 COSTS(000):$0
7 CFR 1930-C, Management and Supervision of Multiple Family
Housing Borrowers and Grant Recipients
FORMS: 1930-5 1930-7 1930-8 1944-8 1944-25 1944-27 1944-29 1951-29
444-27A
OMB NO: 0575-0042 EXPIRATION DATE: 10/31/2003
RESPS:291,631 HOURS:94,924 COSTS(000):$0
7 CFR 1924-A, "Planning and Performing Construction and Other
Development"
FORMS: 1924-1 2 3 4 5 6 7 9 10 11
OMB NO: 0575-0043 EXPIRATION DATE: 04/30/2003
RESPS:3,043 HOURS:3,095 COSTS(000):$0
"Self-Help Technical Assistance Grants" -- 7 CFR 1944-I
FORMS: NONE
OMB NO: 0575-0045 EXPIRATION DATE: 05/31/2004
RESPS:780 HOURS:8,524 COSTS(000):$0
7 CFR 1944-D, Farm Labor Housing Loan and Grant Policies,
Procedures, and Authorization
FORMS: NONE
OMB NO: 0575-0046 EXPIRATION DATE: 10/31/2004
RESPS:200 HOURS:82 COSTS(000):$0
7 CFR 1944-L, Tenant Grievance and Appeals Procedure
FORMS: NONE
OMB NO: 0575-0047 EXPIRATION DATE: 06/30/2003
RESPS:5,102 HOURS:28,246 COSTS(000):$0
7 CFR 1944-E, Rural Rental and Cooperative Housing Loan
Policies, Procedures, and Authorizations
FORMS: RD-1944-7 RD-1944-30 RD-1944-31 RD-1944-33 RD-1944-34 RD-1944-35
RD-1944-38
OMB NO: 0575-0064 EXPIRATION DATE: 07/31/2005
RESPS:4 HOURS:2 COSTS(000):$0
7 CFR 1901-K, "Certificates of Beneficial Ownership and Insured
Notes"
FORMS: RD-471-7
OMB NO: 0575-0066 EXPIRATION DATE: 04/30/2003
RESPS:158 HOURS:118 COSTS(000):$0
7 CFR 1951-E, "Servicing of Community and Direct Business
Programs Loans and Grants"
FORMS: 1951-15 1951-33
OMB NO: 0575-0071 EXPIRATION DATE: 03/31/2006
RESPS:6 HOURS:36 COSTS(000):$0
7 CFR 1822-G, Rural Housing Site Loans, Policies, Procedures and
Authorizations
FORMS: NONE
OMB NO: 0575-0075 EXPIRATION DATE: 06/30/2003
RESPS:110 HOURS:28 COSTS(000):$0
7 CFR 1951-A, "Account Servicing Policies"
FORMS: NONE
OMB NO: 0575-0078 EXPIRATION DATE: 09/30/2003
RESPS:411,004 HOURS:154,250 COSTS(000):$0
7 CFR 1980-D, Rural Housing Loans
FORMS: RD-1980-11 1980-12 1980-13 1980-16 1980-17 1980-18 1980-20
1980-21 1980-80 1980-81
OMB NO: 0575-0082 EXPIRATION DATE: 07/31/2003
RESPS:5,250 HOURS:1,350 COSTS(000):$0
7 CFR 1924-F, Complaints and Compensation for Construction
FORMS: RD-FORM-1924-4
OMB NO: 0575-0087 EXPIRATION DATE: 11/30/2004
RESPS:8,765 HOURS:4,895 COSTS(000):$0
7 CFR Part 1806-A - Real Property Insurance
FORMS: FORM-RD-426-2
OMB NO: 0575-0088 EXPIRATION DATE: 10/31/2004
RESPS:57,800 HOURS:28,900 COSTS(000):$0
Form RD 1940-59, Settlement Statement
FORMS: 1940-59
OMB NO: 0575-0091 EXPIRATION DATE: 04/30/2003
RESPS:85,569 HOURS:28,238 COSTS(000):$0
"Applicant Reference Letter (A Request for Credit Reference)" --
Form RD 410-8
FORMS: RD-410-8
OMB NO: 0575-0093 EXPIRATION DATE: 08/31/2003
RESPS:25,047 HOURS:75,361 COSTS(000):$0
7 CFR 1951-F, Analyzing Credit Needs and Graduation of Borrower
FORMS: NONE
OMB NO: 0575-0094 EXPIRATION DATE: 08/31/2003
RESPS:5,220 HOURS:15,320 COSTS(000):$0
7 CFR 1940 Subpart G Environmental Program
FORMS: RD-1940-G
OMB NO: 0575-0100 EXPIRATION DATE: 10/31/2003
RESPS:945 HOURS:1,587 COSTS(000):$0
7 CFR 1965-B Security Servicing for Multiple Family Housing
Loans.
FORMS: 1944-33A 1944-34A 1944-35A 1965-16
OMB NO: 0575-0104 EXPIRATION DATE: 09/30/2004
RESPS:700 HOURS:800 COSTS(000):$0
7 CFR 1951-N, Sercicing Cases Where Unauthorized Loan or Other
Financial Assistance Was Received--Multiple Family Housing
FORMS: NONE
OMB NO: 0575-0110 EXPIRATION DATE: 01/31/2005
RESPS:292 HOURS:136 COSTS(000):$0
7 CFR, Part 1955-B-Management of Property
FORMS: RD-1955-20
OMB NO: 0575-0114 EXPIRATION DATE: 10/31/2004
RESPS:25 HOURS:2,000 COSTS(000):$0
Rural Housing Demonstration Program - Section 502
FORMS: NONE
OMB NO: 0575-0115 EXPIRATION DATE: 04/30/2003
RESPS:10,555 HOURS:10,814 COSTS(000):$0
"Housing Preservation Grant Program" -- 7 CFR 1944-N
FORMS: NONE
OMB NO: 0575-0118 EXPIRATION DATE: 07/31/2004
RESPS:2,900 HOURS:24,650 COSTS(000):$0
7 CFR 1956-B, Debt Settlement-Farm Programs and Multiple Family
Housing
FORMS: RD-1956-1
OMB NO: 0575-0120 EXPIRATION DATE: 09/30/2004
RESPS:2,921 HOURS:6,482 COSTS(000):$0
7 CFR 1942-C, "Fire and Rescue Loans"
FORMS: 1942-52 1942-53 1942-54
OMB NO: 0575-0124 EXPIRATION DATE: 10/31/2003
RESPS:92 HOURS:880 COSTS(000):$0
7 CFR 1956-C, Debt Settlement - Community and Business Programs
FORMS: NONE
OMB NO: 0575-0137 EXPIRATION DATE: 02/28/2006
RESPS:58,819 HOURS:89,530 COSTS(000):$0
7 CFR 3575-A, Community Programs Guaranteed Loans
FORMS: 449-14 449-30 449-35 449-36 1980-19 1980-43 3575-1
OMB NO: 0575-0147 EXPIRATION DATE: 05/31/2004
RESPS:174,000 HOURS:41,296 COSTS(000):$0
7 CFR 1927-B, "Real Estate Title Clearance and Loan Closing"
FORMS: RD1927-5 RD1927-8 RD1927-9 RD1927-10 RD1927-11 RD1927-12
RD1927-15 RD1927-16 RD1927-19 RD1927-20
OMB NO: 0575-0155 EXPIRATION DATE: 10/31/2003
RESPS:920 HOURS:687 COSTS(000):$0
"Prepayment and Displacement Prevention of Multiple Family
Housing Loans" -- 7 CFR 1965-E
FORMS: NONE
OMB NO: 0575-0157 EXPIRATION DATE: 04/30/2003
RESPS:800 HOURS:900 COSTS(000):$0
Housing Application Packaging Grants -- 7 CFR 1944-B
FORMS: NONE
OMB NO: 0575-0158 EXPIRATION DATE: 01/31/2005
RESPS:62,000 HOURS:26,260 COSTS(000):$0
7 CFR 1902-A, Supervised Bank Accounts
FORMS: RD-402-1
OMB NO: 0575-0172 EXPIRATION DATE: 02/28/2006
RESPS:1,714,622 HOURS:513,872 COSTS(000):$0
7 CFR 3550 - Direct Single Family Housing Loan and Grant
Programs, HB-1-3550, and HB-2-3550
FORMS: NONE
OMB NO: 0575-0173 EXPIRATION DATE: 06/30/2004
RESPS:1,078 HOURS:859 COSTS(000):$0
7 CFR 3570-B, Community Facilities Grant Program
FORMS: FORM-RD-3570-3
OMB NO: 0575-0174 EXPIRATION DATE: 10/31/2005
RESPS:3,005 HOURS:1,581 COSTS(000):$0
7 CFR Part 3565, "Guaranteed Rural Rental Housing Program" and
its supporting handbook
FORMS: 3565-1 3565-2 3565-3 1980-24
OMB NO: 0575-0179 EXPIRATION DATE: 04/30/2003
RESPS:1 HOURS:1 COSTS(000):$0
Guaranteed Rural Housing Loan Program -- 7 CFR Part 3555
FORMS: 1980-11 1980-13 1980-16 1980-20 1980-21
OMB NO: 0575-0180 EXPIRATION DATE: 05/31/2004
RESPS:843 HOURS:1,702 COSTS(000):$0
Notice of Funds Availability (NOFA) Inviting Applications for
the Rural Community Development Initiative (RCDI)
FORMS: NONE
OMB NO: 0575-0181 EXPIRATION DATE: 06/30/2004
RESPS:147 HOURS:175.5 COSTS(000):$0
Farm Labor Housing Technical Assistance Grants
FORMS: NONE
OMB NO: 0575-0184 EXPIRATION DATE: 04/30/2005
RESPS:1,200 HOURS:600 COSTS(000):$0
RD 3550-28, "Authorization Agreement for Preauthorization
Payments", RD 1951-65, "Customer Initiated Payments (CIP)", and
RD 1951-66, "Fedwire Worksheet"
FORMS: RD-3550-28 RD-1951-65 RD-1951-66
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
39 5,425,565 3,928,689 $0
Natural Resources Conservation Service
OMB NO: 0578-0007 EXPIRATION DATE: 05/31/2003
RESPS:768 HOURS:936 COSTS(000):$0
Agriculture and Urban Flood Damage Surveys
FORMS: NRCS-ECN-001 ECN-002 ECN-003 ECN-004 ECN-005 ECN-006
OMB NO: 0578-0013 EXPIRATION DATE: 06/30/2003
RESPS:235,043 HOURS:160,311 COSTS(000):$0
Long Term Contracting
FORMS: CCC-1250 1251 1252 1252A 1252B 1253 1255 1255A 1256 1257
OMB NO: 0578-0018 EXPIRATION DATE: 06/30/2004
RESPS:35,540 HOURS:20,731 COSTS(000):$0
Application for Payment
FORMS: CCC-1202 NRCS-FNM-141
OMB NO: 0578-0024 EXPIRATION DATE: 03/31/2006
RESPS:50,420 HOURS:1,016 COSTS(000):$0
Volunteer Program - Earth Team
FORMS: NRCS-PER-001 NRCS-PER-002 NRCS-PER-003 NRCS-PER-004
OMB NO: 0578-0028 EXPIRATION DATE: 01/31/2005
RESPS:5,000 HOURS:2,917 COSTS(000):$0
Risk Protection Programs
FORMS: CCC-1200 CCC-1245
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
5 326,771 185,911 $0
Animal and Plant Health Inspection Service
OMB NO: 0579-0007 EXPIRATION DATE: 04/30/2003
RESPS:48,135 HOURS:7,451 COSTS(000):$0
National Poultry Improvement Plan (NPIP)
FORMS: VS-9-2 VS-9-3 VS-9-5
OMB NO: 0579-0008 EXPIRATION DATE: 09/30/2005
RESPS:20 HOURS:10 COSTS(000):$0
Application for Inspection and Certification of Animal Byproducts
FORMS: VS-16-24
OMB NO: 0579-0010 EXPIRATION DATE: 02/29/2004
RESPS:35,050 HOURS:1,445 COSTS(000):$0
National Agricultural Pest Information System
FORMS: PPQ-391
OMB NO: 0579-0013 EXPIRATION DATE: 03/31/2005
RESPS:19,472 HOURS:51,177 COSTS(000):$0
Virus-Serum-Toxin Act and Regulations in 9 CFR, Subchapter E,
Parts 101-124
FORMS: 2001 2003 2005 2007 2008 2008A 2015 2020
OMB NO: 0579-0015 EXPIRATION DATE: 03/31/2005
RESPS:51,171 HOURS:17,830 COSTS(000):$0
Importation of Restricted and Controlled Animal and Poultry
Products and Byproducts, Organisms, and Vectors into the US.
FORMS: VS-16-3 VS-16-25 VS-16-26
OMB NO: 0579-0020 EXPIRATION DATE: 08/31/2004
RESPS:42,067 HOURS:21,009 COSTS(000):$0
U.S. Origin Health Certificate
FORMS: VS-17-140
OMB NO: 0579-0032 EXPIRATION DATE: 04/30/2003
RESPS:171,024 HOURS:52,190 COSTS(000):$0
Veterinary Accreditation Program -- 9 CFR 160-162
FORMS: VS-1-36A 4-24 4-26 4-33 4-54 17-145
OMB NO: 0579-0036 EXPIRATION DATE: 04/30/2003
RESPS:119,426 HOURS:95,720 COSTS(000):$0
Animal Welfare
FORMS: APHIS-7001 7001A 7003 7003A 7005 7006 7006A 7009 7011 7019
OMB NO: 0579-0040 EXPIRATION DATE: 04/30/2003
RESPS:2,537,098 HOURS:64,200 COSTS(000):$0
Importation of Animal & Poultry, Animal/Poultry Products,
Certain Animal Embryos, Semen, and Zoological Animals
FORMS: VS17-8 VS17-23 VS-17-135A VS-17-128 VS-17-29 VS-17-129 VS-10-4
VS-17-65C VS-17-65A VS-17-65B
OMB NO: 0579-0047 EXPIRATION DATE: 02/28/2006
RESPS:527,486 HOURS:17,681 COSTS(000):$0
Brucellosis Program Cooperative Agreements - Title 9, CFR Parts
50, 51, 53, 54, 71, 76 and 78
FORMS: 1-23 1-23A 1-27 1-68 4-1 4-1D 4-6 4-59 4-108/4-108A
4-108B/4-108C
OMB NO: 0579-0048 EXPIRATION DATE: 02/28/2005
RESPS:21,000 HOURS:10,500 COSTS(000):$0
Certificate for poultry and hatching eggs for export
FORMS: VS-17-6
OMB NO: 0579-0049 EXPIRATION DATE: 02/28/2006
RESPS:289,440 HOURS:91,138 COSTS(000):$0
Foreign Quarantine Notices
FORMS: 368 546 564 587 588 585
OMB NO: 0579-0051 EXPIRATION DATE: 08/31/2003
RESPS:9,717 HOURS:740 COSTS(000):$0
Permit for Movement of Restricted Animals
FORMS: VS-1-27
OMB NO: 0579-0052 EXPIRATION DATE: 06/30/2005
RESPS:759,992 HOURS:539,681 COSTS(000):$0
Phytosanitary Export Certification
FORMS: 572 577 578 579
OMB NO: 0579-0054 EXPIRATION DATE: 06/30/2003
RESPS:46,974 HOURS:38,133 COSTS(000):$0
Federal Plant Pest and Noxious Weeds Regulations
FORMS: PPQ-FORMS-525A 526 526-1 519
OMB NO: 0579-0055 EXPIRATION DATE: 08/31/2004
RESPS:360 HOURS:90 COSTS(000):$0
Request for Credit Account Approval for Reimbursable Services
FORMS: APHIS-192
OMB NO: 0579-0065 EXPIRATION DATE: 03/31/2005
RESPS:860 HOURS:584 COSTS(000):$0
Swine Health Protection
FORMS: VS-13-2 VS-13-15 VS-13-16 VS-13-7
OMB NO: 0579-0070 EXPIRATION DATE: 02/28/2005
RESPS:80,250 HOURS:5,092 COSTS(000):$0
9 CFR 85 Psuedoriabies
FORMS: 7-1 1-27
OMB NO: 0579-0071 EXPIRATION DATE: 03/31/2005
RESPS:1,070 HOURS:1,070 COSTS(000):$0
Foreign Animal Disease (Emerging Disease Investigation (FAD/EDI)
Database
FORMS: VS-12-27
OMB NO: 0579-0072 EXPIRATION DATE: 02/28/2006
RESPS:23 HOURS:9 COSTS(000):$0
7 CFR 319.76 Exotic Bee Diseases and Parasites, 7 CFR 322
Honeybees and Honeybee Semen
FORMS: 368
OMB NO: 0579-0076 EXPIRATION DATE: 08/31/2005
RESPS:31,933 HOURS:4,738 COSTS(000):$0
Endangered Species Regulations and Forfeiture Procedures
FORMS: 368 621 625 623 626
OMB NO: 0579-0084 EXPIRATION DATE: 10/31/2005
RESPS:53,539 HOURS:17,372 COSTS(000):$0
CFR 50& 77 Tuberculosis
FORMS: 1-23 1-24 1-68 6-22 6-22A 6-22B 6-22C 6-22D 6-35 6-38
OMB NO: 0579-0085 EXPIRATION DATE: 04/30/2005
RESPS:3,464 HOURS:2,984 COSTS(000):$0
7 CFR 340-Intro of Organisms and Products Altered or Produced
Through Genetic Engineering
FORMS: 2000 2050 2051 2052 2053 2054
OMB NO: 0579-0088 EXPIRATION DATE: 07/31/2005
RESPS:1,059,954 HOURS:87,647 COSTS(000):$0
Domestic Quarantines
FORMS: 527 530 537 540 543 586
OMB NO: 0579-0090 EXPIRATION DATE: 09/30/2003
RESPS:30,290 HOURS:15,149 COSTS(000):$0
Specimen Submission
FORMS: VS-10-4
OMB NO: 0579-0092 EXPIRATION DATE: 03/31/2006
RESPS:2,250 HOURS:260 COSTS(000):$0
Animal Welfare, Part 3, Subparts B and C, Guinea Pigs, Hamsters,
and Rabbits
FORMS: 7020 7020A
OMB NO: 0579-0093 EXPIRATION DATE: 06/30/2003
RESPS:72,585 HOURS:44,313 COSTS(000):$0
Animal Welfare Act, Part 3, Subparts A and D, Dogs, cats, Pri-
mates
FORMS: NONE
OMB NO: 0579-0094 EXPIRATION DATE: 10/31/2005
RESPS:223,562 HOURS:7,640 COSTS(000):$0
User Fee Regulations, 7 CFR 354 and 9 CFR 130
FORMS: VS-FORM-16-7 16-3 PPQ-FORM-250 577 578 579
OMB NO: 0579-0101 EXPIRATION DATE: 10/31/2004
RESPS:732,185 HOURS:81,526 COSTS(000):$0
Scrapie Flock Certification, Animal Identification and
Indemnification Procedures
FORMS: VS-5-18 VS-5-19 VS-5-20 VS-5-24 VS-1-23 VS-1-27
OMB NO: 0579-0102 EXPIRATION DATE: 09/30/2005
RESPS:12,224 HOURS:5,078 COSTS(000):$0
Imported Fire Ant
FORMS: 523 518
OMB NO: 0579-0104 EXPIRATION DATE: 06/30/2005
RESPS:240 HOURS:20 COSTS(000):$0
Gypsy Moth Identification Worksheet
FORMS: PPQ-305
OMB NO: 0579-0115 EXPIRATION DATE: 09/30/2005
RESPS:27,398 HOURS:15,607 COSTS(000):$0
Animal Welfare, 9 CFR, Part 3 Marine Mammals
FORMS: APHIS-7002
OMB NO: 0579-0116 EXPIRATION DATE: 01/31/2005
RESPS:57 HOURS:34 COSTS(000):$0
Exotic newcastle disease in birds and poultry; chlamydiosis in
poultry
FORMS: NONE
OMB NO: 0579-0117 EXPIRATION DATE: 03/31/2005
RESPS:3,000 HOURS:1,500 COSTS(000):$0
Environmental Monitoring Form
FORMS: APHIS-2060
OMB NO: 0579-0122 EXPIRATION DATE: 02/28/2005
RESPS:315 HOURS:132 COSTS(000):$0
Asian Lonhorned Beetle Regulations
FORMS: PPQ-527 PPQ-537 PPQ-530 PPQ-540
OMB NO: 0579-0123 EXPIRATION DATE: 04/30/2004
RESPS:2,746 HOURS:327 COSTS(000):$0
Fruit from Hawaii
FORMS: PPQ-519 PPQ-530 PPQ-540
OMB NO: 0579-0124 EXPIRATION DATE: 04/30/2004
RESPS:30,000 HOURS:11,345 COSTS(000):$0
Imported Seed and Screening
FORMS: PPQ-925 PPQ-519
OMB NO: 0579-0127 EXPIRATION DATE: 10/31/2004
RESPS:1,075,003 HOURS:98,156 COSTS(000):$0
9 CFR 75 Communicable Diseases in Horses
FORMS: 10-11 10-12
OMB NO: 0579-0128 EXPIRATION DATE: 11/30/2004
RESPS:500 HOURS:501 COSTS(000):$0
Importation of Fruits and Vegetables
FORMS: NONE
OMB NO: 0579-0129 EXPIRATION DATE: 01/31/2005
RESPS:630 HOURS:743 COSTS(000):$0
Hass Avocado
FORMS: PPQ-587 PPQ-519
OMB NO: 0579-0130 EXPIRATION DATE: 03/31/2005
RESPS:87 HOURS:300 COSTS(000):$0
Export Certification, Accreditation on Non-Government Facilities
FORMS: NONE
OMB NO: 0579-0131 EXPIRATION DATE: 02/28/2005
RESPS:2,448 HOURS:1,704 COSTS(000):$0
Importation of Tomatoes from France, Morocco, Western Sahara,
Chile, Spain
FORMS: NONE
OMB NO: 0579-0132 EXPIRATION DATE: 11/30/2004
RESPS:100 HOURS:120 COSTS(000):$0
Mexicali Valley - Karnal Bunt
FORMS: NONE
OMB NO: 0579-0135 EXPIRATION DATE: 09/30/2005
RESPS:850,000 HOURS:73,950 COSTS(000):$0
Wood Packing Material from China
FORMS: NONE
OMB NO: 0579-0136 EXPIRATION DATE: 05/31/2005
RESPS:1,834 HOURS:1,343 COSTS(000):$0
7 CFR Part 319 - Importation of Fruits and Vegetables
FORMS: PPQ-587(MD)
OMB NO: 0579-0138 EXPIRATION DATE: 03/31/2005
RESPS:40 HOURS:40 COSTS(000):$0
9 CFR part 94 importation of Pork from Yucatan and Sonora, Mexico
FORMS: NONE
OMB NO: 0579-0141 EXPIRATION DATE: 08/31/2003
RESPS:204 HOURS:30 COSTS(000):$0
Poultry Imports and Export
FORMS: NONE
OMB NO: 0579-0142 EXPIRATION DATE: 02/28/2006
RESPS:2,230 HOURS:81 COSTS(000):$0
Importation of Gypsy Moth Host Materials from Canada
FORMS: NONE
OMB NO: 0579-0144 EXPIRATION DATE: 10/31/2005
RESPS:40 HOURS:40 COSTS(000):$0
Importation of Poultry Meat and other Poultry products from
Sinaloa and Sonora, Mexico
FORMS: NONE
OMB NO: 0579-0145 EXPIRATION DATE: 10/31/2005
RESPS:780 HOURS:572 COSTS(000):$0
Poultry and Pork Products Transiting the United States
FORMS: NONE
OMB NO: 0579-0146 EXPIRATION DATE: 08/31/2003
RESPS:2,216 HOURS:766 COSTS(000):$0
Tuberculosis (Docket 99-038-1, TB in Cattle, Bison, and Goats)
Addendum 1
FORMS: VS-6-38 VS-6-22 VS-6-22C VS-6-22D
OMB NO: 0579-0147 EXPIRATION DATE: 06/30/2003
RESPS:162,500 HOURS:2,808 COSTS(000):$0
Conifer Solid Wood Packing Material to China, Export
Certification
FORMS: PPQ-553
OMB NO: 0579-0148 EXPIRATION DATE: 04/30/2003
RESPS:325 HOURS:13 COSTS(000):$0
Johne's Disease in Domestic Animals, Interstate Movement, 9 CFR
80
FORMS: VS-1-27
OMB NO: 0579-0152 EXPIRATION DATE: 07/31/2003
RESPS:95 HOURS:75 COSTS(000):$0
Spanish Pure Breed Horses From Spain
FORMS: NONE
OMB NO: 0579-0153 EXPIRATION DATE: 05/31/2003
RESPS:256 HOURS:192 COSTS(000):$0
Fuji Apples
FORMS: NONE
OMB NO: 0579-0155 EXPIRATION DATE: 07/31/2003
RESPS:1,214,885 HOURS:10,305 COSTS(000):$0
Iradiation Phytosanitary Treatment of Fresh Fruits and Vegetables
FORMS: NONE
OMB NO: 0579-0156 EXPIRATION DATE: 07/31/2004
RESPS:900 HOURS:75 COSTS(000):$0
Interstate Movement of Certain Tortoises
FORMS: APHIS-7001
OMB NO: 0579-0158 EXPIRATION DATE: 03/31/2004
RESPS:11,400 HOURS:11,400 COSTS(000):$0
Importation of Fruits and Vegetables
FORMS: NONE
OMB NO: 0579-0159 EXPIRATION DATE: 05/31/2004
RESPS:12 HOURS:2 COSTS(000):$0
Plum Pox Compensation
FORMS: PPQ-651
OMB NO: 0579-0160 EXPIRATION DATE: 01/31/2004
RESPS:100,100 HOURS:5,008 COSTS(000):$0
Commercial Transportation of Equines to Slaughter
FORMS: VS-10-13
OMB NO: 0579-0161 EXPIRATION DATE: 02/29/2004
RESPS:12,000 HOURS:2,600 COSTS(000):$0
Interstate Movement of Swine Within A Production System
FORMS: NONE
OMB NO: 0579-0162 EXPIRATION DATE: 09/30/2004
RESPS:840 HOURS:945 COSTS(000):$0
West Nile Virus Surveillance Report
FORMS: WNV-1 WNV-2
OMB NO: 0579-0163 EXPIRATION DATE: 05/31/2004
RESPS:65 HOURS:15 COSTS(000):$0
Citrus Canker: Commercial citrus tree replacement program
FORMS: PPQ-652
OMB NO: 0579-0165 EXPIRATION DATE: 10/31/2004
RESPS:136 HOURS:34 COSTS(000):$0
Importation of horses, ruminants, swine, and dogs; inspection
and treatment for screwworm
FORMS: NONE
OMB NO: 0579-0166 EXPIRATION DATE: 04/30/2004
RESPS:200 HOURS:40 COSTS(000):$0
District of Columbia Plant Health Certificate
FORMS: PPQ-571
OMB NO: 0579-0167 EXPIRATION DATE: 01/31/2004
RESPS:9,000 HOURS:153 COSTS(000):$0
Veterinary Services User Fees; Fees for Permit Applications
FORMS: NONE
OMB NO: 0579-0168 EXPIRATION DATE: 01/31/2004
RESPS:65 HOURS:10 COSTS(000):$0
Citrus Canker Payments for Recovery of Lost Production
FORMS: NONE
OMB NO: 0579-0169 EXPIRATION DATE: 02/28/2006
RESPS:32 HOURS:16 COSTS(000):$0
Animal Welfare Licensing and Inspection Requirements for Dealers
of Dogs Intended for Hunting, Breeding, or Security Purpose
FORMS: 7001 7001A 7002 7003 7003A 7005 7006
OMB NO: 0579-0170 EXPIRATION DATE: 09/30/2004
RESPS:37 HOURS:37 COSTS(000):$0
West Indian Fruit Fly
FORMS: FORM-540
OMB NO: 0579-0172 EXPIRATION DATE: 03/31/2004
RESPS:40 HOURS:40 COSTS(000):$0
Importation of Mangoes from the Philippines
FORMS: NONE
OMB NO: 0579-0173 EXPIRATION DATE: 05/31/2004
RESPS:10 HOURS:10 COSTS(000):$0
Importation of Unshu Oranges
FORMS: PPQ-203
OMB NO: 0579-0175 EXPIRATION DATE: 10/31/2004
RESPS:1,455 HOURS:1,373 COSTS(000):$0
Bluetongue Surveillance Pilot Program (BSPP)
FORMS: VS-11-3 VS-11-4 VS-11-5 VS-11-6A VS-11-6B VS-11-7 VS-11-8
VS-11-9
OMB NO: 0579-0176 EXPIRATION DATE: 05/31/2004
RESPS:100 HOURS:25 COSTS(000):$0
Importation of Artifically Dwarfed Plants
FORMS: NONE
OMB NO: 0579-0182 EXPIRATION DATE: 08/31/2004
RESPS:340 HOURS:170 COSTS(000):$0
Karmal Bunt, Compensation for the 1999-2000 Crop Season and
Subsequent Seasons
FORMS: PPQ-926 PPQ-927
OMB NO: 0579-0183 EXPIRATION DATE: 11/30/2004
RESPS:9,000 HOURS:1,494 COSTS(000):$0
BSE - Certificate of Orgin
FORMS: VS-16-3
OMB NO: 0579-0185 EXPIRATION DATE: 10/31/2004
RESPS:4 HOURS:1 COSTS(000):$0
Brucellosis in sheep, goats, horses; Payment of indemnity
FORMS: VS-1-27
OMB NO: 0579-0186 EXPIRATION DATE: 11/30/2004
RESPS:8 HOURS:32 COSTS(000):$0
Black Stem Rust; Identification Requirements and Addition of
Rust-Resistant Varieties
FORMS: NONE
OMB NO: 0579-0188 EXPIRATION DATE: 01/31/2005
RESPS:10,731 HOURS:9,090 COSTS(000):$0
National Animal Health Monitoring System Sheep 2001 Study
FORMS: NAHMS-120 NAHMS-121 NAHMS-123 NAHMS-124 NAHMS-125 NAHMS-126
NAHMS-127 NAHMS-128 NAHMS-122
OMB NO: 0579-0189 EXPIRATION DATE: 09/30/2005
RESPS:10 HOURS:10 COSTS(000):$0
CWD in cervids; Payment of indemnity
FORMS: VS1-23
OMB NO: 0579-0190 EXPIRATION DATE: 03/31/2005
RESPS:20 HOURS:10 COSTS(000):$0
Update of the Nursery Stock Regulation
FORMS: PPQ-203
OMB NO: 0579-0191 EXPIRATION DATE: 09/30/2005
RESPS:16,642 HOURS:1,227 COSTS(000):$0
Phytopthora Ramorum; Quarantine and Regulations
FORMS: PPQ-540 PPQ-519
OMB NO: 0579-0192 EXPIRATION DATE: 09/30/2005
RESPS:697 HOURS:2,934 COSTS(000):$0
ISA-Payment of Indemnity
FORMS: VS-1-22 VS-1-23
OMB NO: 0579-0193 EXPIRATION DATE: 09/30/2004
RESPS:590 HOURS:875 COSTS(000):$0
TB Payments to El Paso Texas
FORMS: VS-1-27
OMB NO: 0579-0195 EXPIRATION DATE: 10/31/2005
RESPS:10,000 HOURS:2,000 COSTS(000):$0
Foot-and-Mouth Disease; Prohibition on Importation of Farm
Equipment
FORMS: NONE
OMB NO: 0579-0196 EXPIRATION DATE: 06/30/2005
RESPS:300 HOURS:50 COSTS(000):$0
Self Certification Medical Statement (SCMS)
FORMS: MRP-5
OMB NO: 0579-0197 EXPIRATION DATE: 07/31/2005
RESPS:85 HOURS:35 COSTS(000):$0
Interstate Movement of Gardenia from Hawaii
FORMS: 530 540 519
OMB NO: 0579-0198 EXPIRATION DATE: 07/31/2005
RESPS:5,380 HOURS:315 COSTS(000):$0
Fruit and Vegetables from Hawaii
FORMS: 519 530 540
OMB NO: 0579-0199 EXPIRATION DATE: 09/30/2005
RESPS:1 HOURS:1 COSTS(000):$0
Foot-and-Mouth Disease Payment of Indemnity; Update of Provisions
FORMS: VS1-23
OMB NO: 0579-0203 EXPIRATION DATE: 10/31/2005
RESPS:8,003,200 HOURS:113,200 COSTS(000):$0
Importation of Clementines from Spain
FORMS: NONE
OMB NO: 0579-0205 EXPIRATION DATE: 12/31/2005
RESPS:8,405 HOURS:6,680 COSTS(000):$0
National Animal Health Monitoring System Dairy 2002
FORMS: 129 139 131 132 133 134 135 136
OMB NO: 0579-0206 EXPIRATION DATE: 12/31/2005
RESPS:1,080 HOURS:495 COSTS(000):$0
Center for Animal Health Monitoring Catfish 2003
FORMS: 138 139
OMB NO: 0579-0208 EXPIRATION DATE: 04/30/2003
RESPS:1,600 HOURS:1,600 COSTS(000):$0
Low Pathogenic AI Payment of Indemnity
FORMS: VS-1-20 VS-1-21 VS-1-23
OMB NO: 0579-0209 EXPIRATION DATE: 02/28/2006
RESPS:1,000 HOURS:1,000 COSTS(000):$0
Viruses, Serums, Toxins, and Analogous Products; Records and
Reports
FORMS: NONE
OMB NO: 0579-0211 EXPIRATION DATE: 02/28/2006
RESPS:168 HOURS:198 COSTS(000):$0
Safeguarding System Definition Project
FORMS: NONE
OMB NO: 0579-0213 EXPIRATION DATE: 08/31/2003
RESPS:9,801 HOURS:25,460 COSTS(000):$0
Select Agent Registeration
FORMS: VS-16-3 VS-16-7 PPQ-526 APHIS-2041 APHIS-2043 VS-16-2 APHIS-2040
APHIS-2042 APHIS-2044
OMB NO: 0579-0215 EXPIRATION DATE: 07/31/2003
RESPS:722 HOURS:462 COSTS(000):$0
Mexican Fruit Fly; Treatments
FORMS: PPQ-519
OMB NO: 0579-0216 EXPIRATION DATE: 08/31/2003
RESPS:108 HOURS:804 COSTS(000):$0
Field Testing of Plants Engineered to Produce Pharmaceutical and
Industrial Compounds
FORMS: 2000
OMB NO: 0579-0220 EXPIRATION DATE: 09/30/2003
RESPS:60,000 HOURS:960 COSTS(000):$0
TB in Cattle and Bison, State Designations; California
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
98 18,636,834 1,694,047 $0
Grain Inspection, Packers and Stockyards Administration
OMB NO: 0580-0013 EXPIRATION DATE: 12/31/2004
RESPS:2,494,098 HOURS:396,937 COSTS(000):$0
Reporting and Recordkeeping Requirements (US Grain Standards Act
and Agricultural Marketing Act of 1946)
FORMS: NONE
OMB NO: 0580-0014 EXPIRATION DATE: 02/28/2005
RESPS:4 HOURS:80 COSTS(000):$0
Guidelines for Preparation of Research Proposal
FORMS: NONE
OMB NO: 0580-0015 EXPIRATION DATE: 09/30/2004
RESPS:25,015 HOURS:304,253 COSTS(000):$0
Regulations and Related Reporting and Recordkeeping
Requirements- Packers and Stockyards Programs
FORMS: 116 116-1 1 333 23 315 316 5 131 135
OMB NO: 0580-0016 EXPIRATION DATE: 10/31/2004
RESPS:1 HOURS:12 COSTS(000):$0
"Clear Title" Regulations to Implement Section 1324 of the Food
Security Act of 1985
FORMS: NONE
OMB NO: 0580-0018 EXPIRATION DATE: 05/31/2003
RESPS:1,874 HOURS:313 COSTS(000):$0
Survey of Customers of the Official Grain Inspection and
Weighing System
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
5 2,520,992 701,595 $0
Agricultural Marketing Service
OMB NO: 0581-0004 EXPIRATION DATE: 06/30/2005
RESPS:304 HOURS:278 COSTS(000):$0
Tobacco Report
FORMS: TB-26 TB-39
OMB NO: 0581-0005 EXPIRATION DATE: 08/31/2005
RESPS:3,864 HOURS:129 COSTS(000):$0
Grain Market News and Molasses Market News Reports
FORMS: NONE
OMB NO: 0581-0006 EXPIRATION DATE: 04/30/2003
RESPS:3,663,030 HOURS:120,964 COSTS(000):$0
Fruit and Vegetable Market News Reports
FORMS: FV-29 FV-498-1 FV-498-2
OMB NO: 0581-0008 EXPIRATION DATE: 05/31/2004
RESPS:1,697 HOURS:119 COSTS(000):$0
Cotton Classing, Testing, and Standards
FORMS: 246 357 383
OMB NO: 0581-0009 EXPIRATION DATE: 05/31/2004
RESPS:2,417 HOURS:226 COSTS(000):$0
Cotton Classification and Market News Service
FORMS: CN-59
OMB NO: 0581-0026 EXPIRATION DATE: 03/31/2004
RESPS:17,697 HOURS:37,215 COSTS(000):$0
Federal Seed Act Program
FORMS: NONE
OMB NO: 0581-0031 EXPIRATION DATE: 09/30/2004
RESPS:40,609 HOURS:155,138 COSTS(000):$0
Reporting and Recordkeeping Requirements Under Regulations
(Other than Rules of Practice) Under the Persihable Agricultural
Commodities Act, 1930
FORMS: FV-211 FV-231 FV-231-2A
OMB NO: 0581-0032 EXPIRATION DATE: 09/30/2004
RESPS:20,026 HOURS:21,397 COSTS(000):$0
Report Forms Under Milk Marketing Order Programs (From Milk
Handlers and Milk Marketing Cooperatives)
FORMS: DA-24 DA-25
OMB NO: 0581-0033 EXPIRATION DATE: 06/30/2004
RESPS:212,740 HOURS:17,657 COSTS(000):$0
Poultry Market News Report
FORMS: PY-90
OMB NO: 0581-0050 EXPIRATION DATE: 09/30/2005
RESPS:18,720 HOURS:624 COSTS(000):$0
Plan for Estimating Daily Livestock Slaughter Under Federal
Inspection
FORMS: NONE
OMB NO: 0581-0055 EXPIRATION DATE: 04/30/2003
RESPS:1,760 HOURS:1,691 COSTS(000):$0
Application for Plant Variety Protection Certificate and
FORMS: ST-470 ST-470-E
OMB NO: 0581-0056 EXPIRATION DATE: 05/31/2004
RESPS:13,504 HOURS:5,569 COSTS(000):$0
Reporting and Recordkeeping Requirements for 7 CFR, Part 29
FORMS: TB-87 TB-92
OMB NO: 0581-0065 EXPIRATION DATE: 02/29/2004
RESPS:1,323 HOURS:162 COSTS(000):$0
Marketing Order Regulating the Handling of Spearmint Oil
Produced in the Far West, M.O. 985
FORMS: FV-57 FV-58 FV-60 FV-63 FV-63A
OMB NO: 0581-0071 EXPIRATION DATE: 07/31/2005
RESPS:7,446 HOURS:2,445 COSTS(000):$0
Almonds Grown in California
FORMS: FV-176 FV-177 FV-178 FV-179 FV-180
OMB NO: 0581-0093 EXPIRATION DATE: 07/31/2004
RESPS:4,389,973 HOURS:344,801 COSTS(000):$0
National Research, Promotion and Consumer Information Program
(HONEY-FINAL RULE)
FORMS: CV-100 DA-15/19/19-1 20/20-1/ FV-182/229/258 261/265
LS-25/26/26-1 35/45R/46/46-1 48/49/50/81/82 PY-1 MAS-735
OMB NO: 0581-0110 EXPIRATION DATE: 03/31/2006
RESPS:487 HOURS:1,388 COSTS(000):$0
Regulations governing the inspection and grading of manufactured
or processed dairy products -- Recordkeeping
FORMS: NONE
OMB NO: 0581-0113 EXPIRATION DATE: 03/31/2006
RESPS:5,988 HOURS:1,749 COSTS(000):$0
Regulations for Inspection of Eggs
FORMS: PY-76 PY-155 PY-156 PY-222 PY-518-1
OMB NO: 0581-0123 EXPIRATION DATE: 04/30/2005
RESPS:23,347 HOURS:1,292 COSTS(000):$0
Reporting Requirements under the Regulations Governing
Inspection and Certification of Processed Fruits and Vegetables
and Related Products
FORMS: FV-159 FV-356 FV-468
OMB NO: 0581-0124 EXPIRATION DATE: 09/30/2003
RESPS:24,000 HOURS:406 COSTS(000):$0
7 CFR Part 54 - Meats, Prepared Meats, and Meat Products
(Grading, Certification, and Standards)
FORMS: LS-313 LS-315
OMB NO: 0581-0125 EXPIRATION DATE: 02/29/2004
RESPS:212,306 HOURS:6,416 COSTS(000):$0
Regulations Governing Inspection, Certification, and Standards
for Fresh Fruits, Vegetables and Other Products -- 7 CFR 51
FORMS: FV-24 FV-202 FV-237 FV-292
OMB NO: 0581-0126 EXPIRATION DATE: 08/31/2003
RESPS:11,991 HOURS:551 COSTS(000):$0
Reporting Requirements under Regulations Governing the
Inspection and Grading Services of Manufactured or Processed
Dairy Products- FINAL RULE
FORMS: DA-132 DA-155 DA-156 DA-162 DA-201B
OMB NO: 0581-0127 EXPIRATION DATE: 06/30/2004
RESPS:22,978 HOURS:1,781 COSTS(000):$0
7 CFR Part 70, Regulations for Voluntary Grading of Poultry
Products and Rabbit Products
FORMS: PY-32 PY-33 PY-210 PY-212
OMB NO: 0581-0128 EXPIRATION DATE: 07/31/2005
RESPS:22,702 HOURS:5,608 COSTS(000):$0
Regulations Governing the Voluntary Grading of Shell Eggs
FORMS: PY-100 PY-157 PY0240
OMB NO: 0581-0140 EXPIRATION DATE: 05/31/2004
RESPS:1,568 HOURS:392 COSTS(000):$0
Seed Service Program
FORMS: NONE
OMB NO: 0581-0142 EXPIRATION DATE: 09/30/2003
RESPS:10,434 HOURS:2,947 COSTS(000):$0
Olives Grown in California
FORMS: COC-149 COC-150
OMB NO: 0581-0143 EXPIRATION DATE: 05/31/2004
RESPS:445 HOURS:2,204 COSTS(000):$0
Export Fruit Regulations--Export Apple Act (7 CFR Part 33) and
Export Grape and Plum Act (7 CFR Part 35)
FORMS: NONE
OMB NO: 0581-0154 EXPIRATION DATE: 02/28/2005
RESPS:234,000 HOURS:7,020 COSTS(000):$0
Livestock and Meat Market News Reports
FORMS: NONE
OMB NO: 0581-0164 EXPIRATION DATE: 06/30/2005
RESPS:190,407,995 HOURS:1,699,596 COSTS(000):$0
Recordkeeping Requirements for Certified Applicators of
Federally Restricted Use Pesticides (7 CFR Part 110)
FORMS: STD-8 STD-8-1
OMB NO: 0581-0167 EXPIRATION DATE: 05/31/2003
RESPS:9,600 HOURS:1,632 COSTS(000):$0
Specified Commodities Imported into the United States Exempt
from Import Requirements, 7 CFR Parts 944, 980, and 999
FORMS: FV-6 FV-7
OMB NO: 0581-0169 EXPIRATION DATE: 03/31/2004
RESPS:1,430 HOURS:358 COSTS(000):$0
Farmer's Market Questionnaire
FORMS: TM-6
OMB NO: 0581-0177 EXPIRATION DATE: 02/29/2004
RESPS:4,649 HOURS:852 COSTS(000):$0
Tart Cherries Grown in the States of Michigan, New York,
Pennsylvania, Oregon, Utah, Washington, and Wisconsin
FORMS: FV-43 FV-43A FV-44 FV-45 FV-45A FV-46 FV-47 FV-48 FV-49
OMB NO: 0581-0178 EXPIRATION DATE: 04/30/2004
RESPS:122,737 HOURS:9,356 COSTS(000):$0
Vegetable and Specialty Crops
FORMS: NONE
OMB NO: 0581-0182 EXPIRATION DATE: 10/31/2004
RESPS:8,400 HOURS:700 COSTS(000):$0
Customer Service Survey for USDA-Donated Food Products
FORMS: AMS-11A 11B 11C
OMB NO: 0581-0183 EXPIRATION DATE: 04/30/2003
RESPS:132 HOURS:3,531 COSTS(000):$0
7 CFR Part 37 - Program to Accredit Organic Certifying Agencies
FORMS: LS-314
OMB NO: 0581-0186 EXPIRATION DATE: 10/31/2004
RESPS:135,824 HOURS:24,414 COSTS(000):$0
Livestock Mandatory Reporting Act of 1999
FORMS: LS-113-126 LS-128 LS-129
OMB NO: 0581-0189 EXPIRATION DATE: 07/31/2004
RESPS:38,736 HOURS:10,717 COSTS(000):$0
Generic OMB Fruit Crops, Marketing Order Administration Branch
FORMS: FV-304
OMB NO: 0581-0190 EXPIRATION DATE: 02/29/2004
RESPS:13,100 HOURS:3,275 COSTS(000):$0
Pricing Pilot Program
FORMS: Q-P Q-C Q-H
OMB NO: 0581-0191 EXPIRATION DATE: 01/31/2004
RESPS:321,635 HOURS:574,877 COSTS(000):$0
National Organic Program - Final Rule
FORMS: N/A
OMB NO: 0581-0192 EXPIRATION DATE: 07/31/2003
RESPS:18,000 HOURS:3,000 COSTS(000):$0
Federal-State Shipping Point Inspection Program Customer Service
Survey
FORMS: FV-600
OMB NO: 0581-0193 EXPIRATION DATE: 06/30/2003
RESPS:428 HOURS:36 COSTS(000):$0
Customer Service Survey (Meat Grading and Certification
Services).
FORMS: NONE
OMB NO: 0581-0194 EXPIRATION DATE: 06/30/2003
RESPS:109,500 HOURS:11,120 COSTS(000):$0
Pork Promotion, Research, and Consumer Information Program:
Procedures for the Conduct of Referendum
FORMS: NONE
OMB NO: 0581-0195 EXPIRATION DATE: 02/29/2004
RESPS:50 HOURS:50 COSTS(000):$0
Marketing Order Committee/Board Interview
FORMS: NONE
OMB NO: 0581-0197 EXPIRATION DATE: 10/31/2004
RESPS:12,903 HOURS:6,134 COSTS(000):$0
Hass Avocados National Research, Promotion and Consumer
Information Program
FORMS: NONE
OMB NO: 0581-0198 EXPIRATION DATE: 08/31/2004
RESPS:185,178 HOURS:67,601 COSTS(000):$0
Lamb Promotion, Reserarch and Information Program - Final Rule
FORMS: LS-78 LS-81 LS-82 LS-83 LS-84 LS-85 AD-755
OMB NO: 0581-0201 EXPIRATION DATE: 07/31/2005
RESPS:1,443 HOURS:250 COSTS(000):$0
California Prune/Plum Tree Removal Program - Section 32 (as
amended 7 USC 622c) -- Final Rule
FORMS: 298 299
OMB NO: 0581-0202 EXPIRATION DATE: 01/31/2005
RESPS:4,504 HOURS:1,304 COSTS(000):$0
Beef Promotion and Research Act of 1985 - Proposed Rule
FORMS: NONE
OMB NO: 0581-0207 EXPIRATION DATE: 03/31/2006
RESPS:672 HOURS:336 COSTS(000):$0
National Research and Promotion Board, Council, and Committee
Membership Background Information
FORMS: AMS-755 AMS-755-PM
OMB NO: 0581-0208 EXPIRATION DATE: 02/28/2006
RESPS:24 HOURS:6 COSTS(000):$0
Dried Prunes Produced in California - Handler Compensation Survey
FORMS: NONE
OMB NO: 0581-0209 EXPIRATION DATE: 02/28/2006
RESPS:173 HOURS:6 COSTS(000):$0
Mango Promotion, Research, and Information Order
FORMS: NONE
OMB NO: 0581-0210 EXPIRATION DATE: 02/28/2006
RESPS:80 HOURS:4 COSTS(000):$0
AMS Research and Promotion Customer Service Survey
FORMS: AMS-13
OMB NO: 0581-0211 EXPIRATION DATE: 02/28/2006
RESPS:15 HOURS:4 COSTS(000):$0
Dried Prunes Produced in California-Prune Dehydrator Survey
FORMS: NONE
OMB NO: 0581-0214 EXPIRATION DATE: 09/30/2003
RESPS:66 HOURS:5 COSTS(000):$0
Sweet Cherries Grown in Designated Counties in Washington, M.O.
923
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
52 200,362,630 3,159,333 $0
Food Safety and Inspection Service
OMB NO: 0583-0082 EXPIRATION DATE: 03/31/2004
RESPS:11,490 HOURS:1,091 COSTS(000):$0
Application for Inspection, Sanitation, Accredited Laboratories
FORMS: 10-600-1 10-110-4 10-110-2 6200-18 5200-8 5200-2 5200-2 PY-38
PY-32
OMB NO: 0583-0092 EXPIRATION DATE: 09/30/2004
RESPS:858 HOURS:119,005 COSTS(000):$0
Marking, Labeling, and Packaging Material
FORMS: FORM-7234-1
OMB NO: 0583-0094 EXPIRATION DATE: 04/30/2003
RESPS:2,201,058 HOURS:168,711 COSTS(000):$0
Exportation, Transportation, and Importation of Meat and Poultry
Products
FORMS: 9060-1 7350-1 9540-1 9510-1
OMB NO: 0583-0103 EXPIRATION DATE: 02/29/2004
RESPS:70,182,657 HOURS:8,559,292 COSTS(000):$243
Pathogen Reduction/Hazard Analysis and Critical Control Point
(HACCP) Systems
FORMS: NONE
OMB NO: 0583-0124 EXPIRATION DATE: 07/31/2003
RESPS:307,500 HOURS:392,100 COSTS(000):$0
E. coli contamination in beef products
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
5 72,703,563 9,240,199 $243
Food and Nutrition Service
OMB NO: 0584-0002 EXPIRATION DATE: 04/30/2003
RESPS:2,976 HOURS:95,232 COSTS(000):$0
Report of School Program Operations
FORMS: FNS-10
OMB NO: 0584-0005 EXPIRATION DATE: 01/31/2006
RESPS:3,368,061 HOURS:702,767 COSTS(000):$0
7 CFR Part 215 - Special Milk Program for Children
FORMS: NONE
OMB NO: 0584-0006 EXPIRATION DATE: 05/31/2004
RESPS:2,210,854 HOURS:9,462,622 COSTS(000):$0
7 CFR Part 210 National School Lunch Program
FORMS: FNS-66 FNS-640 FNS-67
OMB NO: 0584-0008 EXPIRATION DATE: 05/31/2003
RESPS:40,190 HOURS:9,447 COSTS(000):$0
Food Stamp Program - Store Applications
FORMS: FNS-252 FNS-252-2
OMB NO: 0584-0009 EXPIRATION DATE: 08/31/2004
RESPS:5,700 HOURS:17,100 COSTS(000):$0
Food coupon Accountability Report
FORMS: FNS-250
OMB NO: 0584-0012 EXPIRATION DATE: 05/31/2004
RESPS:1,283,639 HOURS:4,895,796 COSTS(000):$0
7 CFR Part 220 School Breakfast Program
FORMS: NONE
OMB NO: 0584-0015 EXPIRATION DATE: 12/31/2004
RESPS:800 HOURS:67 COSTS(000):$0
Food Stamp Mail Issuance Report
FORMS: FNS-259
OMB NO: 0584-0022 EXPIRATION DATE: 09/30/2004
RESPS:1,326 HOURS:663 COSTS(000):$0
Requisition for Food Coupon Books
FORMS: FNS-260
OMB NO: 0584-0025 EXPIRATION DATE: 05/31/2003
RESPS:2,939 HOURS:6,595 COSTS(000):$0
Civil Rights Title VI-Collection Reports-FNS-191 and FNS-101
FORMS: FNS-191 FNS-101
OMB NO: 0584-0026 EXPIRATION DATE: 08/31/2004
RESPS:12,193,997 HOURS:1,021,272 COSTS(000):$0
7 CFR 245, Determining Eligibility for F & RP Meals and Free Milk
FORMS: NONE
OMB NO: 0584-0034 EXPIRATION DATE: 05/31/2003
RESPS:33,178 HOURS:101,049 COSTS(000):$0
Negative Quality Control Review Schedule; Status of Sample
Selection and Completion; Statistical Summary of Sample
Disposition
FORMS: FNS-245 FNS-247 FNS-248
OMB NO: 0584-0037 EXPIRATION DATE: 03/31/2005
RESPS:100 HOURS:97 COSTS(000):$0
Report of Coupon Issuance & Commodity Distribution for Disaster
Relief
FORMS: FNS-292
OMB NO: 0584-0041 EXPIRATION DATE: 06/30/2003
RESPS:1,590 HOURS:1,193 COSTS(000):$0
Summer Food Service Program Claim for Reimbursement
FORMS: FNS-143
OMB NO: 0584-0043 EXPIRATION DATE: 01/31/2004
RESPS:26,149,238 HOURS:2,734,330 COSTS(000):$0
WIC Program Regulations - Reporting and Recordkeeping Burden
FORMS: NONE
OMB NO: 0584-0045 EXPIRATION DATE: 07/31/2005
RESPS:17 HOURS:4,660 COSTS(000):$0
WIC Financial Management and Participation Report with Addendum
FORMS: FNS-798 FNS-798A
OMB NO: 0584-0052 EXPIRATION DATE: 03/31/2005
RESPS:30,000 HOURS:7,500 COSTS(000):$0
Affidavit of Return or Exchange of Food Coupons
FORMS: FNS-135
OMB NO: 0584-0053 EXPIRATION DATE: 06/30/2003
RESPS:111,312 HOURS:12,127 COSTS(000):$0
Coupon Account and Destruction Report
FORMS: FNS-471
OMB NO: 0584-0055 EXPIRATION DATE: 12/31/2003
RESPS:4,804,928 HOURS:5,093,852 COSTS(000):$0
7 CFR Part 226 Child and Adult Care Food Program
FORMS: FNS-82 341 342 344 345 430 431 433
OMB NO: 0584-0064 EXPIRATION DATE: 01/31/2006
RESPS:149,135,163 HOURS:29,422,927 COSTS(000):$0
Food Stamp Forms: Applications, Periodic Reporting, Notices
FORMS: NONE
OMB NO: 0584-0067 EXPIRATION DATE: 09/30/2005
RESPS:2,052 HOURS:12,922 COSTS(000):$0
7 CFR Part 235 State Administrative Expense Funds
FORMS: FNS-74 FNS-525
OMB NO: 0584-0069 EXPIRATION DATE: 05/31/2003
RESPS:212 HOURS:742 COSTS(000):$0
Status of Claims Against Households
FORMS: FNS-209
OMB NO: 0584-0074 EXPIRATION DATE: 11/30/2003
RESPS:54,663 HOURS:491,967 COSTS(000):$0
Worksheet for Food Stamp Program Quality Control Reveiws, FNS-380
FORMS: FNS-380
OMB NO: 0584-0075 EXPIRATION DATE: 10/31/2004
RESPS:54 HOURS:4,320 COSTS(000):$0
Annual Report of State Revenue Matching
FORMS: FNS-13
OMB NO: 0584-0078 EXPIRATION DATE: 04/30/2003
RESPS:1,908 HOURS:5,724 COSTS(000):$0
Report of the Child and Adult Care Food Program
FORMS: FNS-44
OMB NO: 0584-0080 EXPIRATION DATE: 10/31/2004
RESPS:2,808 HOURS:22,416 COSTS(000):$0
Issuance Reconciliation Report
FORMS: FNS-46
OMB NO: 0584-0081 EXPIRATION DATE: 11/30/2003
RESPS:636 HOURS:4,542 COSTS(000):$0
Form FNS-388, State Issuance and Participation Estimates
FORMS: FNS-388
OMB NO: 0584-0083 EXPIRATION DATE: 12/31/2005
RESPS:253 HOURS:2,932 COSTS(000):$0
Operating Guidelines, Forms and Waivers
FORMS: 366-A 366-B
OMB NO: 0584-0085 EXPIRATION DATE: 02/28/2005
RESPS:6,797,351 HOURS:135,947 COSTS(000):$0
Food Stamp Redemption Certificate
FORMS: FNS-278B FNS-278-4
OMB NO: 0584-0124 EXPIRATION DATE: 11/30/2003
RESPS:3,951,516 HOURS:21,250 COSTS(000):$0
Food Stamp Program Identification Cards
FORMS: NONE
OMB NO: 0584-0280 EXPIRATION DATE: 04/30/2003
RESPS:347,641 HOURS:316,005 COSTS(000):$0
Summer Food Service Program -- 7 CFR Part 225
FORMS: FNS-19-1 FNS-19-2 FNS-80 FNS-81 FNS-81-1 FNS-418 FNS-688
OMB NO: 0584-0284 EXPIRATION DATE: 04/30/2003
RESPS:5,200 HOURS:7,540 COSTS(000):$0
Monthly claim for Reimbursement
FORMS: FNS-806
OMB NO: 0584-0293 EXPIRATION DATE: 06/30/2003
RESPS:918,593 HOURS:1,154,581 COSTS(000):$0
Food Distribution Forms
FORMS: FNS-7 52 53 57 152 153 155 586A 586B 663
OMB NO: 0584-0299 EXPIRATION DATE: 10/31/2003
RESPS:54,663 HOURS:58,686 COSTS(000):$0
Quality Control Review Schedule
FORMS: FNS-380-1
OMB NO: 0584-0303 EXPIRATION DATE: 08/31/2004
RESPS:4,326 HOURS:3,830 COSTS(000):$0
Food Stamp Program Regulations, Part 275 - Quality Control
FORMS: NONE
OMB NO: 0584-0314 EXPIRATION DATE: 09/30/2004
RESPS:136,534 HOURS:1,327 COSTS(000):$0
Food Coupon Deposit Document
FORMS: FNS-521
OMB NO: 0584-0320 EXPIRATION DATE: 04/30/2003
RESPS:4,163 HOURS:3,122 COSTS(000):$0
Child Nutrition Labeling Program
FORMS: NONE
OMB NO: 0584-0332 EXPIRATION DATE: 05/31/2003
RESPS:100 HOURS:25 COSTS(000):$0
WIC Federal and State Agreement
FORMS: FNS-339
OMB NO: 0584-0336 EXPIRATION DATE: 03/31/2006
RESPS:6 HOURS:60 COSTS(000):$0
Disaster Food Stamp Program
FORMS: NONE
OMB NO: 0584-0339 EXPIRATION DATE: 12/31/2004
RESPS:3,386,325 HOURS:190,541 COSTS(000):$0
Employment and Training (E&T) Program Report
FORMS: FNS-583
OMB NO: 0584-0385 EXPIRATION DATE: 04/30/2003
RESPS:275 HOURS:963 COSTS(000):$0
Report of the Emergency Food Assistance Program (TEFAP)
Administrative
FORMS: FNS-667
OMB NO: 0584-0401 EXPIRATION DATE: 09/30/2004
RESPS:1 HOURS:1,778 COSTS(000):$0
The Integrity Profile
FORMS: FNS-698 FNS-699 FNS-700
OMB NO: 0584-0431 EXPIRATION DATE: 02/28/2005
RESPS:1 HOURS:15 COSTS(000):$0
WIC Local Agency Directory Report
FORMS: FNS-648
OMB NO: 0584-0446 EXPIRATION DATE: 04/30/2003
RESPS:843,623 HOURS:71,803 COSTS(000):$0
Federal Collection; Methods for Food Stamp Program Recipient
Claims
FORMS: N/A
OMB NO: 0584-0447 EXPIRATION DATE: 02/28/2005
RESPS:2,009 HOURS:4,912 COSTS(000):$0
WIC Farmers' Market Nutrition Program (FMNP) Forms: 683, 203 &
Regulations
FORMS: FNS-683 FNS-203
OMB NO: 0584-0474 EXPIRATION DATE: 05/31/2003
RESPS:1,850 HOURS:148 COSTS(000):$0
A National Hunger Clearinghouse Data Base Form
FORMS: NONE
OMB NO: 0584-0479 EXPIRATION DATE: 08/31/2005
RESPS:69 HOURS:1,380 COSTS(000):$0
Waivers Under Section 6(0) of the Food Stamp Act
FORMS: NONE
OMB NO: 0584-0492 EXPIRATION DATE: 11/30/2004
RESPS:1,536,129 HOURS:162,560 COSTS(000):$0
Repayment Demand and Program Disqualification
FORMS: NONE
OMB NO: 0584-0494 EXPIRATION DATE: 02/28/2005
RESPS:100 HOURS:2,500 COSTS(000):$0
Child Nutrition Database
FORMS: FNS-709 FNS-710
OMB NO: 0584-0496 EXPIRATION DATE: 09/30/2004
RESPS:135 HOURS:256 COSTS(000):$0
Food Stamp Program: State agency options
FORMS: NONE
OMB NO: 0584-0501 EXPIRATION DATE: 05/31/2003
RESPS:800 HOURS:66 COSTS(000):$0
Supplemental Form for Collecting Taxpayer Identifying Numbers
FORMS: FNS-711
OMB NO: 0584-0505 EXPIRATION DATE: 03/31/2004
RESPS:15,942 HOURS:7,817 COSTS(000):$0
Evaluation of the School Breakfast Pilot Program
FORMS: NONE
OMB NO: 0584-0512 EXPIRATION DATE: 05/31/2005
RESPS:505 HOURS:30,000 COSTS(000):$0
Uniform Grant Application for Non-Entitlement Discretionary
Grants
FORMS: FNS-728
OMB NO: 0584-0513 EXPIRATION DATE: 06/30/2003
RESPS:630 HOURS:274 COSTS(000):$0
14 State Summer Food Service Program Pilot Project
FORMS: NONE
OMB NO: 0584-0515 EXPIRATION DATE: 03/31/2004
RESPS:1,113 HOURS:672 COSTS(000):$0
Case Study of NSLP Verification outcomes in large metropplitan
ares
FORMS: NONE
OMB NO: 0584-0516 EXPIRATION DATE: 10/31/2003
RESPS:3,216 HOURS:2,308 COSTS(000):$0
Evaluation of the NSLP Application and Verification and Pilot
Program
FORMS: NONE
OMB NO: 0584-0517 EXPIRATION DATE: 09/30/2003
RESPS:6,186 HOURS:3,532 COSTS(000):$0
Nutrition Education Materials for Food and Nutrition Service
Population Groups
FORMS: NONE
OMB NO: 0584-0521 EXPIRATION DATE: 03/31/2006
RESPS:7,500 HOURS:1,250 COSTS(000):$0
Interactive Healthy eating Index Questionnaire
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
57 217,465,096 56,320,009 $0
Forest Service
OMB NO: 0596-0003 EXPIRATION DATE: 04/30/2003
RESPS:7,200 HOURS:2,950 COSTS(000):$0
Grazing Permit Administration Forms
FORMS: R1-FS-2200-5 R2-2200-6 R#-FS-2200-1 R8-2200-23 FS-220-1/2/12
13/15/16/17
OMB NO: 0596-0009 EXPIRATION DATE: 03/31/2004
RESPS:2,919 HOURS:199 COSTS(000):$0
Residential Fuelwood and Post Assessment, Any State, Year
FORMS: NONE
OMB NO: 0596-0010 EXPIRATION DATE: 06/30/2003
RESPS:2,909 HOURS:2,369 COSTS(000):$0
Forest Industries Data Collection System
FORMS: NONE
OMB NO: 0596-0015 EXPIRATION DATE: 05/31/2003
RESPS:988 HOURS:248 COSTS(000):$0
Airplane Pilot Qualifications and Approval Record, Helicopter
Pilot Qualifications and Approval Record, Airplane Data Record,
and Helicopter Data Record.
FORMS: FS-5700-20 FS-5700-20A FS-5700-21 FS-5700-21A
OMB NO: 0596-0016 EXPIRATION DATE: 07/31/2003
RESPS:2,000 HOURS:500 COSTS(000):$0
Use of Roads by Order
FORMS: FS-7700-40
OMB NO: 0596-0017 EXPIRATION DATE: 04/30/2004
RESPS:20 HOURS:20 COSTS(000):$0
Timber Purchasers' Cost and Sales Data
FORMS: NONE
OMB NO: 0596-0019 EXPIRATION DATE: 11/30/2003
RESPS:320,000 HOURS:16,000 COSTS(000):$0
Recreation Fee Permit and Visitor Registration Card
FORMS: FS-2300-30 FS-2300-32
OMB NO: 0596-0022 EXPIRATION DATE: 07/31/2005
RESPS:4,208 HOURS:13,174 COSTS(000):$0
36 CFR Part 228, Subpart A-Locatable Minerals
FORMS: FS-2800-5
OMB NO: 0596-0025 EXPIRATION DATE: 05/31/2004
RESPS:50 HOURS:25 COSTS(000):$0
Annual Wildfire Summary Report
FORMS: FS-3100-8
OMB NO: 0596-0066 EXPIRATION DATE: 05/31/2003
RESPS:1,600 HOURS:38,672 COSTS(000):$0
Bid for Advertised Timber
FORMS: FS-2400-42A FS-2400-14
OMB NO: 0596-0078 EXPIRATION DATE: 12/31/2004
RESPS:10,000 HOURS:2,500 COSTS(000):$0
National Woodland Owner Survey
FORMS: NONE
OMB NO: 0596-0080 EXPIRATION DATE: 04/30/2004
RESPS:58,100 HOURS:14,525 COSTS(000):$0
Volunteer Application for Natural Resource Agencies
FORMS: FORM-301
OMB NO: 0596-0081 EXPIRATION DATE: 05/31/2004
RESPS:3,000 HOURS:7,500 COSTS(000):$0
36 CFR Part 228, Subpart C-Disposal of Mineral Materials
FORMS: FS-2800-9
OMB NO: 0596-0082 EXPIRATION DATE: 04/30/2003
RESPS:56,940 HOURS:75,875 COSTS(000):$0
Special Use Administration
FORMS: NONE
OMB NO: 0596-0084 EXPIRATION DATE: 09/30/2003
RESPS:18,000 HOURS:6,000 COSTS(000):$0
Youth Conservation Corps Application & Medical History Forms.
FORMS: FS-1800-3 FS-1800-18
OMB NO: 0596-0085 EXPIRATION DATE: 03/31/2005
RESPS:27,750 HOURS:41,366 COSTS(000):$0
Forest Products Free Use Permit, Forest Products Removal Permit
and Cash Receipt, and Forest Products Sale Permit and Cash
Receipt
FORMS: FS-2400-8 FS-2400-1 FS-2400-4
OMB NO: 0596-0086 EXPIRATION DATE: 01/31/2004
RESPS:3,750 HOURS:1,875 COSTS(000):$0
Operating Plans
FORMS: NONE
OMB NO: 0596-0087 EXPIRATION DATE: 03/31/2004
RESPS:40 HOURS:20 COSTS(000):$0
Commercial Use of Woodsy Owl Symbol-36 CFR Part 272
FORMS: NONE
OMB NO: 0596-0089 EXPIRATION DATE: 11/30/2003
RESPS:25 HOURS:6 COSTS(000):$0
Application for Prospecting Permit
FORMS: FS-2800-14
OMB NO: 0596-0099 EXPIRATION DATE: 12/31/2003
RESPS:6,500 HOURS:1,083 COSTS(000):$0
Application for the Senior Communitry Service Employment Program
FORMS: FS-1800-21B
OMB NO: 0596-0105 EXPIRATION DATE: 06/30/2003
RESPS:200 HOURS:200 COSTS(000):$0
Agreement to Initiate (ATI) and Exchange Agreement (EA)
FORMS: NONE
OMB NO: 0596-0106 EXPIRATION DATE: 04/30/2003
RESPS:400,000 HOURS:20,000 COSTS(000):$0
Recreation Fee Permit Envelope
FORMS: FS-2300-26
OMB NO: 0596-0108 EXPIRATION DATE: 04/30/2003
RESPS:1,000 HOURS:416 COSTS(000):$0
Baseline and Trend Information on Wilderness Use and Users
FORMS: NONE
OMB NO: 0596-0110 EXPIRATION DATE: 04/30/2003
RESPS:57,000 HOURS:9,917 COSTS(000):$0
Customer and Use Survey Techniques for Operations, Management,
Evaluation, and Research
FORMS: NONE
OMB NO: 0596-0127 EXPIRATION DATE: 10/31/2003
RESPS:40,000 HOURS:13,333 COSTS(000):$0
National Survey on Recreation and the Environment
FORMS: NONE
OMB NO: 0596-0129 EXPIRATION DATE: 03/31/2006
RESPS:600 HOURS:150 COSTS(000):$0
Day Use on the National Forests of Southern California
FORMS: NONE
OMB NO: 0596-0141 EXPIRATION DATE: 05/31/2005
RESPS:80 HOURS:320 COSTS(000):$0
Small Business Timber Set-Aside Program: Appeal Procedures on
Recompution of Shares
FORMS: NONE
OMB NO: 0596-0146 EXPIRATION DATE: 09/30/2005
RESPS:15,000 HOURS:1,000 COSTS(000):$0
How Are We Doing? Customer Service Comment Card
FORMS: FS-1300-5
OMB NO: 0596-0149 EXPIRATION DATE: 03/31/2004
RESPS:9,250 HOURS:3,043 COSTS(000):$0
Public Information Survey for the Recreation Fee Demonstration
Programs at Sedona, AZ on the Coconino National Forest and the
Pacific Northwest Region
FORMS: NONE
OMB NO: 0596-0158 EXPIRATION DATE: 10/31/2003
RESPS:1,210 HOURS:12,100 COSTS(000):$0
National Forest System Land and Resource Management Planning
FORMS: NONE
OMB NO: 0596-0161 EXPIRATION DATE: 04/30/2004
RESPS:20,000 HOURS:1,667 COSTS(000):$0
Forest Stewarship and Stewardship Incentive Program Participant
Demographics
FORMS: NONE
OMB NO: 0596-0162 EXPIRATION DATE: 08/31/2004
RESPS:1,600 HOURS:800 COSTS(000):$0
Improve Management of the Tongass National Forest and Service to
Southeast Alaska Residents
FORMS: NONE
OMB NO: 0596-0163 EXPIRATION DATE: 07/31/2004
RESPS:22,000 HOURS:1,833 COSTS(000):$0
Title Publication Comment Card
FORMS: NONE
OMB NO: 0596-0164 EXPIRATION DATE: 08/31/2004
RESPS:1,500 HOURS:1,250 COSTS(000):$0
Health Screen Questionarie (HSQ)
FORMS: FS-5100-30 FS-5100-31
OMB NO: 0596-0167 EXPIRATION DATE: 04/30/2003
RESPS:25 HOURS:50 COSTS(000):$0
Urgent Removal of Timber
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
35 1,095,464 290,986 $0
AGENCY TOTALS:
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
479 546,557,927 97,375,727 $84,993
Department of Commerce
General Administration
OMB NO: 0605-0001 EXPIRATION DATE: 04/30/2003
RESPS:2,710 HOURS:678 COSTS(000):$0
Applicant for Funding Assistance
FORMS: CD-346-LF
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
1 2,710 678 $0
Bureau of the Census
OMB NO: 0607-0008 EXPIRATION DATE: 07/31/2003
RESPS:72,000 HOURS:24,000 COSTS(000):$0
Manufacturers' Shipments, Inventories, and Orders Survey
FORMS: M-3(SD) M3-SD(I) M3-1-L1
OMB NO: 0607-0013 EXPIRATION DATE: 10/31/2005
RESPS:22,977 HOURS:9,299 COSTS(000):$0
Annual Retail Trade Survey
FORMS: SA-44 SA-44A SA-44C SA-44E SA-44N SA-44S SA-45 SA-45C SA-721
OMB NO: 0607-0049 EXPIRATION DATE: 07/31/2005
RESPS:684,000 HOURS:18,012 COSTS(000):$0
Current Population Survey (CPS) Basic Demographics
FORMS: CPS263 CPS263(SP) CPS263A CPS264 CPS264(SP) CPS264A CPS266
BC1428 BC-1428(SP) BC1428(SP)
OMB NO: 0607-0094 EXPIRATION DATE: 02/29/2004
RESPS:113,600 HOURS:20,693 COSTS(000):$0
Report of Privately-owned Residential Building or Zoning Permits
FORMS: C-404
OMB NO: 0607-0104 EXPIRATION DATE: 12/31/2003
RESPS:54,000 HOURS:4,500 COSTS(000):$0
Advance Monthly Retail Sales Survey
FORMS: SM-44(00)A SM-44(00)AS SM-44(00)AE SM-72(00)A
OMB NO: 0607-0110 EXPIRATION DATE: 07/31/2003
RESPS:112,736 HOURS:9,395 COSTS(000):$0
Survey of Housing Starts, Sales, and Completion
FORMS: SOC-QI/SF.1 SOC-QI/MF.1
OMB NO: 0607-0112 EXPIRATION DATE: 09/30/2003
RESPS:23,616 HOURS:5,957 COSTS(000):$0
Quarterly Survey of State and Local Tax Revenues
FORMS: F-71 F-72 F-73
OMB NO: 0607-0117 EXPIRATION DATE: 06/30/2004
RESPS:11,106 HOURS:1,775 COSTS(000):$266
U.S. Census - Age Search
FORMS: BC-600 BC-649(L) BC-658(L)
OMB NO: 0607-0125 EXPIRATION DATE: 05/31/2003
RESPS:900 HOURS:225 COSTS(000):$0
Questionnaire for Building Permit Officials
FORMS: SOC-QBPO
OMB NO: 0607-0130 EXPIRATION DATE: 12/31/2005
RESPS:9,600 HOURS:2,400 COSTS(000):$0
Quarterly Survey of Residential Alterations and Repairs
FORMS: SORAR-705
OMB NO: 0607-0139 EXPIRATION DATE: 08/31/2005
RESPS:16,600 HOURS:4,150 COSTS(000):$0
Census Employment Inquiry
FORMS: BC-170
OMB NO: 0607-0143 EXPIRATION DATE: 01/31/2006
RESPS:400 HOURS:300 COSTS(000):$0
Quarterly Survey of Public Employee-Retirement Systems
FORMS: F10
OMB NO: 0607-0151 EXPIRATION DATE: 11/30/2004
RESPS:13,662 HOURS:40,986 COSTS(000):$0
Boundary and Annexation Survey (BAS)
FORMS: BAS-1 BAS-1A BAS-2 BAS-2A BAS-2CUO BAS-3 BAS-3A BAS-4 BAS-5
BAS-5A
OMB NO: 0607-0152 EXPIRATION DATE: 04/30/2005
RESPS:15,043,756 HOURS:944,188 COSTS(000):$1,000
Shipper's Export Declaration (SED)/Automated Export System (AES)
Program
FORMS: 7525-V AES
OMB NO: 0607-0153 EXPIRATION DATE: 04/30/2004
RESPS:161,280 HOURS:40,320 COSTS(000):$0
Construction Project Reporting Surveys (Private Construction
Projects (C-700), State and Local Governments Projects (C-700
(SL)), and Multifamily Residential Projects (C-700(R))
FORMS: C-700 C-700(SL) C-700(R)
OMB NO: 0607-0175 EXPIRATION DATE: 09/30/2004
RESPS:17,250 HOURS:38,813 COSTS(000):$0
Survey of Plant Capacity Utilization
FORMS: MQC1
OMB NO: 0607-0179 EXPIRATION DATE: 10/31/2005
RESPS:69,120 HOURS:3,456 COSTS(000):$0
Housing Vacancy Survey (HVS)
FORMS: NONE
OMB NO: 0607-0189 EXPIRATION DATE: 08/31/2005
RESPS:43,600 HOURS:9,448 COSTS(000):$0
Business and Professional Classification Report
FORMS: SQ-CLASS
OMB NO: 0607-0190 EXPIRATION DATE: 07/31/2005
RESPS:45,600 HOURS:5,320 COSTS(000):$0
Monthly Wholesale Trade Survey
FORMS: SM-42(00)
OMB NO: 0607-0195 EXPIRATION DATE: 10/31/2004
RESPS:6,000 HOURS:2,364 COSTS(000):$0
Annual Trade Survey
FORMS: SA-42 SA-42A
OMB NO: 0607-0206 EXPIRATION DATE: 08/31/2004
RESPS:5,835 HOURS:2,059 COSTS(000):$0
Current Industrial Reports (CIR) Program (WAVE II-Voluntary)
FORMS: M327G M331J MQ311A MQ325A MQ325C MQ335F MQ335C MA311D MA333N
MA335L
OMB NO: 0607-0350 EXPIRATION DATE: 03/31/2005
RESPS:2,000 HOURS:500 COSTS(000):$0
Survey of Building and Zoning Permit Systems
FORMS: C-411
OMB NO: 0607-0354 EXPIRATION DATE: 10/31/2003
RESPS:80,550 HOURS:33,563 COSTS(000):$0
Annual Demographic Survey -- 2001
FORMS: CPS-580 CPS-580(SP) CPS-676 CPS-676(SP)
OMB NO: 0607-0368 EXPIRATION DATE: 05/31/2005
RESPS:851,525 HOURS:114,421 COSTS(000):$0
Special Census Program
FORMS: SC-1 SC-1SUPP SC-2 SC-920 SC-116 SC-351 SC-921(HU) SC-921(SP)
OMB NO: 0607-0392 EXPIRATION DATE: 08/31/2003
RESPS:13,661 HOURS:8,522 COSTS(000):$0
Current Industrial Reports Program (WAVE-I Mandatory)
FORMS: M311H M311M M311N MA325F MA327C MA331A MA331B MA331E MA333A
MA333M
OMB NO: 0607-0393 EXPIRATION DATE: 08/31/2003
RESPS:3,322 HOURS:2,092 COSTS(000):$0
Current Industrial Reports (CIR) Program (WAVE I - Voluntary)
FORMS: M336L MQ325B MQ327D MQ332E
OMB NO: 0607-0395 EXPIRATION DATE: 08/31/2004
RESPS:24,012 HOURS:15,115 COSTS(000):$0
Current Industrial Reports Program (WAVE-II - Mandatory)
FORMS: MA316A MA321T MA325G M311J M311L M313N M313P MQ314X MQ315A
MQ333W
OMB NO: 0607-0404 EXPIRATION DATE: 05/31/2005
RESPS:500 HOURS:59 COSTS(000):$0
Field Representative Exit Questionnaire, Enumerator Exit
Questionnaire
FORMS: BC-1294 BC-1294(D)
OMB NO: 0607-0422 EXPIRATION DATE: 10/31/2005
RESPS:48,686 HOURS:39,822 COSTS(000):$0
Service Annual Survey
FORMS: SA-484 SA-492 SA-493 SA-511 SA-512 SA-513 SA-514 SA-523 SA-532
SA-541
OMB NO: 0607-0432 EXPIRATION DATE: 07/31/2004
RESPS:37,800 HOURS:77,708 COSTS(000):$0
Quarterly Financial Report (QFR)
FORMS: QFR-101(MG) 101A(MG) 102(TR) 103(NB)
OMB NO: 0607-0444 EXPIRATION DATE: 11/30/2003
RESPS:182,000 HOURS:91,255 COSTS(000):$0
2002 Company Organization Survey
FORMS: NC-99001
OMB NO: 0607-0452 EXPIRATION DATE: 01/31/2005
RESPS:96,591 HOURS:14,542 COSTS(000):$0
Government Employment Forms
FORMS: E-1 E-2 E-3 E-4 E-5 E-6 E-7 E-9
OMB NO: 0607-0459 EXPIRATION DATE: 09/30/2004
RESPS:30 HOURS:15 COSTS(000):$0
School Enrollment Report
FORMS: P-4
OMB NO: 0607-0464 EXPIRATION DATE: 08/31/2005
RESPS:57,000 HOURS:4,275 COSTS(000):$0
The 2002 October School Enrollment Supplement to the Current
Population Survey
FORMS: NONE
OMB NO: 0607-0466 EXPIRATION DATE: 09/30/2003
RESPS:48,000 HOURS:1,200 COSTS(000):$0
Current Population Survey (CPS) - November Voting and
Registration Supplement
FORMS: NONE
OMB NO: 0607-0476 EXPIRATION DATE: 09/30/2005
RESPS:11,641 HOURS:10,274 COSTS(000):$0
Current Industrial Reports (CIR) Program (Wave III-Mandatory and
Voluntary)
FORMS: M311H-M311L M311M-M311N M336G-MQ313D MQ313T-MA311D MA315D-MA327E
MA333D-MA333F MA333N MA334P MA334R MA335L
OMB NO: 0607-0585 EXPIRATION DATE: 03/31/2005
RESPS:47,981 HOURS:115,076 COSTS(000):$0
Governments - Finance Forms
FORMS: F-5 F-11 F-12 F-13 F-21 F-22 F-25 F-28 F-29 F-32
OMB NO: 0607-0700 EXPIRATION DATE: 08/31/2003
RESPS:3,500 HOURS:3,737 COSTS(000):$0
Annual Survey of Local Government Finances, School Systems
FORMS: F-33 F-33-1 F-33-L1 F-33-L2 F-33-L3
OMB NO: 0607-0717 EXPIRATION DATE: 06/30/2005
RESPS:113,004 HOURS:14,761 COSTS(000):$0
Current Retail Sales and Inventory Survey
FORMS: SM-44(00)S SM-44(00)SE SM-44(00)SS SM-44(00)B SM-44(00)BE
SM-44(00)BS SM-44(00)L SM-20(00)LE SM-44(00)LS SM-45(00)S
OMB NO: 0607-0725 EXPIRATION DATE: 08/31/2004
RESPS:5,500 HOURS:5,500 COSTS(000):$0
Questionnaire Pretesting Research
FORMS: NONE
OMB NO: 0607-0760 EXPIRATION DATE: 09/30/2004
RESPS:8,000 HOURS:4,000 COSTS(000):$0
Data User Evaluation Surveys
FORMS: VARIOUS
OMB NO: 0607-0782 EXPIRATION DATE: 02/29/2004
RESPS:61,000 HOURS:145,000 COSTS(000):$0
Annual Capital Expenditures Survey
FORMS: ACE-1(S) ACE-1(M) ACE-1(LONG) ACE-1(I) ACE-2 ACE-2(I)
OMB NO: 0607-0809 EXPIRATION DATE: 04/30/2004
RESPS:114,500 HOURS:3,725 COSTS(000):$0
MAF and TIGER Update Activities
FORMS: NONE
OMB NO: 0607-0810 EXPIRATION DATE: 06/30/2005
RESPS:3,063,000 HOURS:1,927,300 COSTS(000):$0
The American Community Survey
FORMS: ACS-1(2003) ACS-1(2003)PR ACS-1(GQ) ACS-3(GQ) ACS-4(GQ) ACS-290
OMB NO: 0607-0875 EXPIRATION DATE: 02/29/2004
RESPS:243,750 HOURS:119,378 COSTS(000):$0
2001 Panel of the Survey of Income and Program Participation,
Wave 8 Topical Modules
FORMS: 21805(L) SIPP/CAPI 21003
OMB NO: 0607-0879 EXPIRATION DATE: 09/30/2003
RESPS:3,000 HOURS:15,600 COSTS(000):$0
Census 2000 Count Question Resolution Program
FORMS: NONE
OMB NO: 0607-0880 EXPIRATION DATE: 06/30/2004
RESPS:480,000 HOURS:720,000 COSTS(000):$0
2002 Economic Census Covering the Wholesale Trade Sector
FORMS: SEE-ATTACHED
OMB NO: 0607-0881 EXPIRATION DATE: 06/30/2004
RESPS:1,615,029 HOURS:1,282,100 COSTS(000):$0
2002 Economic Census Covering the Retail Trade and Accommodation
and Food Services Sectors
FORMS: SEE-ATTACHED
OMB NO: 0607-0882 EXPIRATION DATE: 07/31/2004
RESPS:633,007 HOURS:829,579 COSTS(000):$0
2002 Economic Census Covering Utilities; Transportation and
Warehousing; Finance and Insurance, and Real Estate and Rental
and Leasing Sectors
FORMS: SEE-ATTACHED
OMB NO: 0607-0883 EXPIRATION DATE: 07/31/2004
RESPS:160,000 HOURS:45,833 COSTS(000):$0
2002 Economic Census Classification Report
FORMS: NC-99026
OMB NO: 0607-0884 EXPIRATION DATE: 07/31/2004
RESPS:400,000 HOURS:66,666 COSTS(000):$0
2002 Economic Census General Classification Report
FORMS: NC-99023 NC-99023-L-1 NC-99023-L-11 NC-99500
OMB NO: 0607-0886 EXPIRATION DATE: 08/31/2004
RESPS:2,442,300 HOURS:48,846 COSTS(000):$0
2002 Economic Census Ownership or Control Flier
FORMS: SEE-ATTACHED
OMB NO: 0607-0887 EXPIRATION DATE: 09/30/2004
RESPS:1,556,857 HOURS:1,403,061 COSTS(000):$0
2002 Economic Census Covering Information; Professional,
Scientific, and Technical Services; Management of Companies and
Enterprise; Administrative and Support and Waste Management ...
FORMS: SEE-ATTACHED
OMB NO: 0607-0888 EXPIRATION DATE: 09/30/2004
RESPS:90,000 HOURS:22,500 COSTS(000):$0
2002 Census of Governments Local Government Directory Survey
FORMS: G-26 G-28 G-29 G-30 G-32 G-33
OMB NO: 0607-0889 EXPIRATION DATE: 10/31/2004
RESPS:200,000 HOURS:400,000 COSTS(000):$0
2002 Economic Census - Commodity Flow Survey (CFS)
FORMS: CFS-1000
OMB NO: 0607-0892 EXPIRATION DATE: 08/31/2004
RESPS:135,300 HOURS:85,170 COSTS(000):$0
2002 Vehicle Inventory and Use Survey
FORMS: TC-9501 TC-9502
OMB NO: 0607-0893 EXPIRATION DATE: 08/31/2004
RESPS:130,000 HOURS:325,000 COSTS(000):$0
2002 Economic Census Covering the Construction Sector
FORMS: CC-23601 CC-23701 CC-23702 CC-23703 CC-23801 CC-23802 CC-23803
CC-23804 CC-23806 CC-23807
OMB NO: 0607-0894 EXPIRATION DATE: 06/30/2004
RESPS:61,500 HOURS:55,750 COSTS(000):$0
2002 Economic Census of Puerto Rico and Island Areas, covering
Puerto Rico, U.S. Virgin Islands, Guam, the Commonwealth of the
Northern Mariana Islands, and American Samoa
FORMS: OA-97120 OA-97220 OA-97123 OA-97223 OA-97130 OA-97230 OA-97142
OA-97242 OA-97144 OA-97244
OMB NO: 0607-0897 EXPIRATION DATE: 08/31/2004
RESPS:14,500 HOURS:55,080 COSTS(000):$0
2002 Economic Census Covering the Mining Sector
FORMS: MI-21101 MI-21102 MI-21201 MI-21202 MI-21203 MI-21204 MI-21205
MI-21206 MI-21207 MI-21208
OMB NO: 0607-0899 EXPIRATION DATE: 08/31/2004
RESPS:260,000 HOURS:940,200 COSTS(000):$0
2002 Economic Census Covering the Manufacturing Sector
FORMS: MA10000 MC31000 MC33000
OMB NO: 0607-0900 EXPIRATION DATE: 12/31/2003
RESPS:240,000 HOURS:40,000 COSTS(000):$0
2003 National Census Test
FORMS: DA-11A DA-1B DA-1C DA-1D DA-1DD DA-1(RH-1) DA-1(RH-2) DA-1(RH-3)
DA-1(RH-4) DA-1(RH-6)
OMB NO: 0607-0901 EXPIRATION DATE: 12/31/2003
RESPS:95,375 HOURS:158,710 COSTS(000):$0
2002 Business Expenses Survey
FORMS: SA-5678(B)
OMB NO: 0607-0902 EXPIRATION DATE: 12/31/2005
RESPS:2,500,000 HOURS:416,666 COSTS(000):$0
2002 Survey of Business Owners and Self-Employed Persons
FORMS: SBO-1 SBO-2
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
63 32,662,059 10,850,261 $1,266
Economic and Statistical Analysis
OMB NO: 0608-0002 EXPIRATION DATE: 07/31/2005
RESPS:1,336 HOURS:3,273 COSTS(000):$0
Institutional Remittances to Foreign Countries (Form BE-40)
FORMS: BE-40
OMB NO: 0608-0004 EXPIRATION DATE: 11/30/2003
RESPS:50,000 HOURS:62,500 COSTS(000):$0
Direct Transactions of U.S. Reporter with Foreign Affiliate
FORMS: BE-577
OMB NO: 0608-0009 EXPIRATION DATE: 12/31/2005
RESPS:15,800 HOURS:19,750 COSTS(000):$0
Transactions of U.S. Affiliate, Except a U.S. Banking Affiliate,
with Foreign Parent (BE-605); and Transactions of U.S. Banking
Affiliate with Foreign Parent (BE-605 Bank)
FORMS: BE-605 BE-605-BANK
OMB NO: 0608-0011 EXPIRATION DATE: 10/31/2004
RESPS:248 HOURS:1,148 COSTS(000):$0
Ocean Freight Revenues and Expenses of United States Carriers
(BE-30) U.S. Airline Operators' Foreign Revenues and Expenses
(BE-37)
FORMS: BE-30 BE-37
OMB NO: 0608-0012 EXPIRATION DATE: 05/31/2004
RESPS:160 HOURS:640 COSTS(000):$0
Foreign Ocean Carriers' Expenses in the United States
FORMS: BE-29
OMB NO: 0608-0013 EXPIRATION DATE: 05/31/2004
RESPS:72 HOURS:360 COSTS(000):$0
Foreign Airline Operators' Revenues and Expenses in the United
States
FORMS: BE-36
OMB NO: 0608-0015 EXPIRATION DATE: 12/31/2004
RESPS:155 HOURS:700 COSTS(000):$0
Annual Survey of Construction, Engineering, Architectural, and
Mining Services Provided by U.S. Firms to Unaffiliated Foreign
Persons
FORMS: BE-47
OMB NO: 0608-0016 EXPIRATION DATE: 10/31/2004
RESPS:325 HOURS:1,300 COSTS(000):$0
Annual Survey of Reinsurance and Other Insurance Transactions by
US Insurance Companies with Foreign Persons
FORMS: 48
OMB NO: 0608-0017 EXPIRATION DATE: 11/30/2003
RESPS:350 HOURS:1,400 COSTS(000):$0
Annual Survey of Royalties, License Fees, and Other Receipts and
Payments for Intangible Rights Between U.S.
FORMS: BE-98
OMB NO: 0608-0034 EXPIRATION DATE: 10/31/2004
RESPS:4,975 HOURS:128,000 COSTS(000):$0
Annual Survey of Foreign Direct Investment in the United States
FORMS: BE-15(LF) BE-15(SF) BE-15(SUPP-C)
OMB NO: 0608-0035 EXPIRATION DATE: 12/31/2003
RESPS:1,200 HOURS:1,800 COSTS(000):$0
Initial Report on a Foreign Person's Direct or Indirect
Acquisition, Establishment, or Purchase of the Operating Assets,
of a U.S. Business Enterprise, Including Real Estate (BE-13); and
FORMS: BE-13 BE-14
OMB NO: 0608-0042 EXPIRATION DATE: 12/31/2005
RESPS:17,700 HOURS:199,500 COSTS(000):$0
Benchmark Survey of Foreign Direct Investment in the United
States - 2002
FORMS: BE-12(LF) BE-12(SF) BE-12-BANK BE-12(X)
OMB NO: 0608-0053 EXPIRATION DATE: 11/30/2003
RESPS:1,500 HOURS:102,600 COSTS(000):$0
Annual Survey of U.S. Direct Investment Abroad (BE-11)
FORMS: BE-11A BE-11B(LF) BE-11B(SF) BE-11C
OMB NO: 0608-0058 EXPIRATION DATE: 10/31/2004
RESPS:1,100 HOURS:13,200 COSTS(000):$0
Benchmark Survey of Selected Services Transactions with
Unaffili- ated Foreign Persons
FORMS: 20
OMB NO: 0608-0060 EXPIRATION DATE: 10/31/2005
RESPS:1,600 HOURS:18,400 COSTS(000):$0
Annual Survey of Selected Services Transaction with Unaffiliated
Foreign Persons
FORMS: BE-22
OMB NO: 0608-0063 EXPIRATION DATE: 09/30/2003
RESPS:375 HOURS:2,600 COSTS(000):$0
Annual Survey of Financial Services Transactions Between U.S.
Financial Services Providers and Unaffiliated Foreign Persons
FORMS: BE-82
OMB NO: 0608-0064 EXPIRATION DATE: 12/31/2003
RESPS:1 HOURS:800 COSTS(000):$0
STAT-USA Customer Satisfaction Survey
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
17 96,897 557,971 $0
Economic Development Administration
OMB NO: 0610-0091 EXPIRATION DATE: 03/31/2005
RESPS:193 HOURS:1,544 COSTS(000):$0
Petition by a Firm for Certification of Eligibility to Apply for
Trade Adjustment Assistance
FORMS: ED-840P
OMB NO: 0610-0093 EXPIRATION DATE: 12/31/2005
RESPS:640 HOURS:34,430 COSTS(000):$77
Guidelines for Comprehensive Economic Development Strategy
FORMS: NONE
OMB NO: 0610-0094 EXPIRATION DATE: 02/28/2006
RESPS:1,900 HOURS:48,700 COSTS(000):$104
Proposal for Federal Assistance and Application for Federal
Assistance
FORMS: ED-900P ED-900A ED-900R
OMB NO: 0610-0095 EXPIRATION DATE: 09/30/2005
RESPS:1,254 HOURS:15,448 COSTS(000):$0
Revolving Loan Fund Reporting Requirements
FORMS: ED-209A ED-209S ED-209I
OMB NO: 0610-0096 EXPIRATION DATE: 02/28/2006
RESPS:1,160 HOURS:23,200 COSTS(000):$0
Requirements for Approved Construction Investments-Ninth Edition
(Revised)
FORMS: NONE
OMB NO: 0610-0097 EXPIRATION DATE: 02/29/2004
RESPS:50 HOURS:150 COSTS(000):$1
Award for Excellence in Economic Development
FORMS: NONE
OMB NO: 0610-0098 EXPIRATION DATE: 06/30/2005
RESPS:2,469 HOURS:21,009 COSTS(000):$0
Data Collection for Compliance with Government Performance and
Results Act of 1993 (GPRA)
FORMS: ED-915 ED-916 ED-917 ED-918
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
7 7,666 144,481 $182
International Trade Administration
OMB NO: 0625-0034 EXPIRATION DATE: 06/30/2005
RESPS:2,000 HOURS:167 COSTS(000):$0
Mission/Exhibition Evaluation
FORMS: ITA-4075P
OMB NO: 0625-0035 EXPIRATION DATE: 05/31/2005
RESPS:2,000 HOURS:1,000 COSTS(000):$0
Product Characteristics-Design Check-Off Lists
FORMS: ITA-426P
OMB NO: 0625-0037 EXPIRATION DATE: 07/31/2004
RESPS:50 HOURS:100 COSTS(000):$0
Request for Duty-Free Entry of Scientific Instrument or Apparatus
FORMS: ITA-338P
OMB NO: 0625-0039 EXPIRATION DATE: 03/31/2005
RESPS:1,000 HOURS:490 COSTS(000):$0
Overseas Business Interest Questionnaire
FORMS: ITA-471P
OMB NO: 0625-0040 EXPIRATION DATE: 11/30/2005
RESPS:14 HOURS:14 COSTS(000):$0
Application of License to Enter Watches and Watch Movements into
the Customs Territory of the U.S. - Public Law 97-446
FORMS: ITA-334P
OMB NO: 0625-0047 EXPIRATION DATE: 05/31/2005
RESPS:4,000 HOURS:3,000 COSTS(000):$0
Marketing Data Form
FORMS: ITA-466P
OMB NO: 0625-0055 EXPIRATION DATE: 08/31/2004
RESPS:40 HOURS:40 COSTS(000):$0
NATO ICB Bidders List Application
FORMS: ITA-4023P
OMB NO: 0625-0061 EXPIRATION DATE: 07/31/2005
RESPS:2,200 HOURS:733 COSTS(000):$0
Commercial News USA
FORMS: ITA-4063P
OMB NO: 0625-0065 EXPIRATION DATE: 07/31/2004
RESPS:60 HOURS:1,644 COSTS(000):$0
Application for the President's "E" and "E Star" Awards for
Export Expansion
FORMS: 725A
OMB NO: 0625-0105 EXPIRATION DATE: 07/31/2005
RESPS:55 HOURS:2,200 COSTS(000):$0
Petition Format for Requesting Relief Under U.S. Antidumping
Duty Law
FORMS: ITA-357P
OMB NO: 0625-0109 EXPIRATION DATE: 12/31/2004
RESPS:150 HOURS:13,352 COSTS(000):$0
Annual Report from Foreign-Trade Zones
FORMS: ITA-359P
OMB NO: 0625-0118 EXPIRATION DATE: 10/31/2004
RESPS:4,560 HOURS:304 COSTS(000):$0
Information on Articles for Physically or Mentally Handicapped
Persons Imported Free of Duty
FORMS: ITA-362P
OMB NO: 0625-0120 EXPIRATION DATE: 07/31/2005
RESPS:12,000 HOURS:3,000 COSTS(000):$0
Export Trading Companies Contact Faciliation Services
FORMS: ITA-4094P
OMB NO: 0625-0125 EXPIRATION DATE: 06/30/2005
RESPS:30 HOURS:960 COSTS(000):$0
Application for an Export Trade Certificate of Review
FORMS: ITA-4093P
OMB NO: 0625-0130 EXPIRATION DATE: 05/31/2005
RESPS:90 HOURS:900 COSTS(000):$0
Trade Fair Certification Program: Application
FORMS: ITA-4100P
OMB NO: 0625-0134 EXPIRATION DATE: 12/31/2005
RESPS:394 HOURS:66 COSTS(000):$0
Wach Duty-Exemption and 7114 Jewelry Duty-Refund Program
FORMS: ITA-340P ITA-360P ITA-361P
OMB NO: 0625-0139 EXPIRATION DATE: 12/31/2004
RESPS:100 HOURS:9,314 COSTS(000):$0
Foreign-Trade Zone Application
FORMS: NONE
OMB NO: 0625-0143 EXPIRATION DATE: 07/31/2005
RESPS:2,675 HOURS:483 COSTS(000):$0
Information Services Order Form
FORMS: ITA-4096P
OMB NO: 0625-0147 EXPIRATION DATE: 04/30/2003
RESPS:7,500 HOURS:2,792 COSTS(000):$0
Participation Agreement and Trade Mission Application
FORMS: ITA-4008P ITA-4008P-1 ITA-4008P-A
OMB NO: 0625-0148 EXPIRATION DATE: 12/31/2003
RESPS:5 HOURS:200 COSTS(000):$0
Format for Petition Requesting Relief Under U.S. Countervailing
Duty Law
FORMS: ITA-366P
OMB NO: 0625-0151 EXPIRATION DATE: 12/31/2003
RESPS:5,510 HOURS:1,060 COSTS(000):$0
International Buyer Program: Application and Exhibitor Data
FORMS: 4014P 4102P
OMB NO: 0625-0200 EXPIRATION DATE: 12/31/2005
RESPS:1 HOURS:15 COSTS(000):$0
Antidumping and Countervailing Duties, Procedures for Initiation
of Downstream Product Monitoring
FORMS: 4119P
OMB NO: 0625-0211 EXPIRATION DATE: 07/31/2005
RESPS:384 HOURS:1,152 COSTS(000):$0
U.S.-Japan Semiconductor Agreement Data Collection Program
FORMS: ITA-4115P
OMB NO: 0625-0215 EXPIRATION DATE: 05/31/2005
RESPS:60 HOURS:60 COSTS(000):$0
Certified Trade Mission: Application for Status
FORMS: ITA-4127P
OMB NO: 0625-0217 EXPIRATION DATE: 07/31/2005
RESPS:21,280 HOURS:3,381 COSTS(000):$0
User Satisfaction Surveys
FORMS: ITA-4107P ITA-4110P
OMB NO: 0625-0220 EXPIRATION DATE: 03/31/2005
RESPS:430 HOURS:205 COSTS(000):$0
Advocacy Questionnaire
FORMS: ITA-4133P
OMB NO: 0625-0224 EXPIRATION DATE: 10/31/2004
RESPS:265 HOURS:465 COSTS(000):$0
American Management and Business Internship Training (AMBIT)
Program: Applications
FORMS: NONE
OMB NO: 0625-0225 EXPIRATION DATE: 10/31/2004
RESPS:3,035 HOURS:6,793 COSTS(000):$0
SABIT: Applications and Questionnaires
FORMS: NONE
OMB NO: 0625-0227 EXPIRATION DATE: 07/31/2005
RESPS:1 HOURS:24,840 COSTS(000):$0
Survey of International Air Travelers
FORMS: NONE
OMB NO: 0625-0228 EXPIRATION DATE: 12/31/2003
RESPS:200 HOURS:100 COSTS(000):$0
Application for Designation of a Fair
FORMS: 4135P
OMB NO: 0625-0231 EXPIRATION DATE: 09/30/2004
RESPS:200 HOURS:33 COSTS(000):$0
BISNIS FinanceLink
FORMS: NONE
OMB NO: 0625-0232 EXPIRATION DATE: 09/30/2003
RESPS:2,000 HOURS:350 COSTS(000):$0
Internet Export Finance Matchmaker
FORMS: NONE
OMB NO: 0625-0236 EXPIRATION DATE: 11/30/2005
RESPS:2,040 HOURS:170 COSTS(000):$0
BISNIS Publication Subscription Form
FORMS: NONE
OMB NO: 0625-0237 EXPIRATION DATE: 12/31/2005
RESPS:9,250 HOURS:1,250 COSTS(000):$0
Export Assistance Center Internet Website Form
FORMS: NONE
OMB NO: 0625-0238 EXPIRATION DATE: 08/31/2003
RESPS:50 HOURS:100 COSTS(000):$0
U.S. Government Trade Information Request
FORMS: ITA-4136P
OMB NO: 0625-0239 EXPIRATION DATE: 05/31/2004
RESPS:1,500 HOURS:550 COSTS(000):$0
Information for Certification Under FAQ 6 of the Safe Harbor
Privacy Principles
FORMS: NONE
OMB NO: 0625-0240 EXPIRATION DATE: 07/31/2004
RESPS:68 HOURS:352 COSTS(000):$0
Imports of Certain Worsted Wool Fabric: Implementation of Tariff
Rate Quotas Established Under Title VI of the Trade and
Development Act of 2000.
FORMS: ITA-4139P ITA-4140P
OMB NO: 0625-0241 EXPIRATION DATE: 04/30/2004
RESPS:200 HOURS:33 COSTS(000):$0
Non-Tariffs Barriers Survey
FORMS: NONE
OMB NO: 0625-0245 EXPIRATION DATE: 09/30/2005
RESPS:1,000,000 HOURS:166,667 COSTS(000):$0
Steel Import License
FORMS: 4141P
OMB NO: 0625-0246 EXPIRATION DATE: 09/30/2003
RESPS:1,600 HOURS:400 COSTS(000):$0
ITA Customer Satisfaction Survey
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
40 1,086,997 248,735 $0
Minority Business Development Agency
OMB NO: 0640-0002 EXPIRATION DATE: 12/31/2005
RESPS:2,670 HOURS:5,473 COSTS(000):$0
Online Performance Database, the Online Phoenix Database and the
Online Opportunity Database
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
1 2,670 5,473 $0
National Oceanic and Atmospheric Administration
OMB NO: 0648-0007 EXPIRATION DATE: 07/31/2004
RESPS:100 HOURS:50 COSTS(000):$0
Coast Pilot Report
FORMS: FORM-77-6
OMB NO: 0648-0009 EXPIRATION DATE: 03/31/2005
RESPS:760 HOURS:62 COSTS(000):$0
Billfish Tagging Report
FORMS: 88-162
OMB NO: 0648-0012 EXPIRATION DATE: 04/30/2005
RESPS:1,250 HOURS:10,000 COSTS(000):$5
Fisheries Finance Program Requirements
FORMS: 88-1
OMB NO: 0648-0013 EXPIRATION DATE: 08/31/2004
RESPS:19,812 HOURS:3,171 COSTS(000):$0
Southeast Region Dealer and Interview Family of Forms
FORMS: NONE
OMB NO: 0648-0015 EXPIRATION DATE: 10/31/2004
RESPS:1,236 HOURS:165 COSTS(000):$0
Monthly Cold Storage Report
FORMS: 88-16
OMB NO: 0648-0016 EXPIRATION DATE: 12/31/2003
RESPS:63,849 HOURS:14,086 COSTS(000):$0
Southeast Region Logbook Family of Forms
FORMS: NONE
OMB NO: 0648-0018 EXPIRATION DATE: 12/31/2004
RESPS:1,400 HOURS:680 COSTS(000):$0
Processed Products Family of Forms
FORMS: 88-13 88-13C
OMB NO: 0648-0020 EXPIRATION DATE: 05/31/2003
RESPS:750 HOURS:63 COSTS(000):$0
Pacific Billfish Angler Survey
FORMS: 88-10
OMB NO: 0648-0021 EXPIRATION DATE: 06/30/2004
RESPS:1,600 HOURS:213 COSTS(000):$0
Small-Craft Facility Questionnaire
FORMS: NOAA-FORM-77-1
OMB NO: 0648-0022 EXPIRATION DATE: 12/31/2004
RESPS:15,000 HOURS:45,000 COSTS(000):$0
Cooperative Charting Programs
FORMS: 77-4 77-5
OMB NO: 0648-0025 EXPIRATION DATE: 09/30/2004
RESPS:110 HOURS:330 COSTS(000):$0
Weather Modification Activities Reports
FORMS: 17-4 17-4A 17-4B
OMB NO: 0648-0040 EXPIRATION DATE: 01/31/2004
RESPS:1,550 HOURS:390 COSTS(000):$1
Bluefin Tuna Statistical Document
FORMS: NONE
OMB NO: 0648-0041 EXPIRATION DATE: 05/31/2003
RESPS:5,000 HOURS:1,650 COSTS(000):$27
Capital Construction Fund - Deposit/Withdrawal Report
FORMS: 38-42
OMB NO: 0648-0052 EXPIRATION DATE: 11/30/2004
RESPS:770,504 HOURS:34,887 COSTS(000):$0
Marine Recreational Fisheries Statistics Survey
FORMS: NONE
OMB NO: 0648-0075 EXPIRATION DATE: 07/31/2004
RESPS:2,350 HOURS:422 COSTS(000):$0
Foreign Fishing Reporting Requirements
FORMS: NONE
OMB NO: 0648-0082 EXPIRATION DATE: 10/31/2004
RESPS:400 HOURS:2,017 COSTS(000):$1
Fishermen's Contingency Fund
FORMS: 88-164 88-166
OMB NO: 0648-0084 EXPIRATION DATE: 07/31/2003
RESPS:604 HOURS:6,476 COSTS(000):$1
Scientific Research, Public Display, and Enhancement Permits
Under the Marine Mammal Protection Act, the Fur Seal Act, and
the Endangered Species Act
FORMS: NONE
OMB NO: 0648-0089 EXPIRATION DATE: 03/31/2005
RESPS:25 HOURS:25 COSTS(000):$9
Foreign Fishing Vessel Permit Applications
FORMS: NONE
OMB NO: 0648-0090 EXPIRATION DATE: 06/30/2004
RESPS:1,000 HOURS:2,250 COSTS(000):$3
Interim Capital Construction Fund Agreement and Certificate
Family of Forms
FORMS: NOAA-FORM-88-14
OMB NO: 0648-0119 EXPIRATION DATE: 11/30/2004
RESPS:195 HOURS:6,598 COSTS(000):$0
Coastal Zone Management Program Administration
FORMS: NONE
OMB NO: 0648-0121 EXPIRATION DATE: 05/31/2004
RESPS:32 HOURS:14,180 COSTS(000):$31
Management and Oversight of the National Estuarine Research
Reserve System
FORMS: NONE
OMB NO: 0648-0135 EXPIRATION DATE: 10/31/2004
RESPS:310 HOURS:985 COSTS(000):$3
Saltonstall-Kennedy Grant Program (S-K Program) Applications and
Reports
FORMS: 88-204 88-205
OMB NO: 0648-0141 EXPIRATION DATE: 04/30/2005
RESPS:801 HOURS:1,018 COSTS(000):$1
National Marine Sanctuary Permits
FORMS: NONE
OMB NO: 0648-0145 EXPIRATION DATE: 05/31/2005
RESPS:2 HOURS:40 COSTS(000):$0
Deep Seabed Mining Regulations for Exploration Licenses
FORMS: NONE
OMB NO: 0648-0148 EXPIRATION DATE: 08/31/2004
RESPS:1,175 HOURS:117 COSTS(000):$0
Pacific Tuna Fisheries Logbook
FORMS: NONE
OMB NO: 0648-0151 EXPIRATION DATE: 03/31/2004
RESPS:78 HOURS:7,512 COSTS(000):$1,673
Applications and Reporting Requirements for Small Takes of
Marine Mammals by Specified Activities Under the Marine Mammal
Protection Act
FORMS: NONE
OMB NO: 0648-0157 EXPIRATION DATE: 05/31/2004
RESPS:390 HOURS:440 COSTS(000):$0
NOAA Space-Based Data Collection System (DCS) Agreements
FORMS: NONE
OMB NO: 0648-0174 EXPIRATION DATE: 03/31/2004
RESPS:67 HOURS:314 COSTS(000):$1
Licensing of Private Land Remote-Sensing Space Systems
FORMS: NONE
OMB NO: 0648-0175 EXPIRATION DATE: 03/31/2005
RESPS:130 HOURS:145 COSTS(000):$0
Marine Fisheries Initiative (MARFIN) Research and Development
Grant and Cooperative Agreement Applications
FORMS: NONE
OMB NO: 0648-0178 EXPIRATION DATE: 03/31/2004
RESPS:4,800 HOURS:1,600 COSTS(000):$2
Marine Mammal Stranding Report/Marine Mammal Rehabilitation
Disposition Report
FORMS: FORM-89-864
OMB NO: 0648-0179 EXPIRATION DATE: 12/31/2005
RESPS:51 HOURS:102 COSTS(000):$0
Applications and Reports for Registration as a Tanner or Agent
FORMS: NONE
OMB NO: 0648-0192 EXPIRATION DATE: 03/31/2005
RESPS:195 HOURS:110 COSTS(000):$0
Statement of Financial Interests, Regional Fishery Management
Councils
FORMS: 88-195
OMB NO: 0648-0194 EXPIRATION DATE: 02/29/2004
RESPS:7,032 HOURS:567 COSTS(000):$70
Antarctic Living Marine Resources Conservation and Management
Measures
FORMS: NONE
OMB NO: 0648-0202 EXPIRATION DATE: 03/31/2004
RESPS:610,877 HOURS:22,292 COSTS(000):$1,368
Northeast Region Permit Family of Forms
FORMS: NONE
OMB NO: 0648-0203 EXPIRATION DATE: 06/30/2003
RESPS:2,610 HOURS:605 COSTS(000):$26
Northwest Region Federal Fisheries Permits
FORMS: NONE
OMB NO: 0648-0204 EXPIRATION DATE: 09/30/2003
RESPS:427 HOURS:248 COSTS(000):$0
Southwest Region Permit Family of Forms
FORMS: NONE
OMB NO: 0648-0205 EXPIRATION DATE: 12/31/2003
RESPS:50,712 HOURS:15,434 COSTS(000):$1,222
Southeast Region Permit Family of Forms
FORMS: NONE
OMB NO: 0648-0206 EXPIRATION DATE: 09/30/2003
RESPS:941 HOURS:492 COSTS(000):$1
Alaska Region Permit Family of Forms
FORMS: NONE
OMB NO: 0648-0212 EXPIRATION DATE: 07/31/2005
RESPS:64,750 HOURS:5,940 COSTS(000):$25
Northeast Region Logbook Family of Forms
FORMS: 88-30 88-140
OMB NO: 0648-0213 EXPIRATION DATE: 07/31/2005
RESPS:76,846 HOURS:32,329 COSTS(000):$128
Alaska Region Logbook Family of Forms
FORMS: NONE
OMB NO: 0648-0214 EXPIRATION DATE: 09/30/2003
RESPS:1,030,692 HOURS:2,339 COSTS(000):$3
Southwest Region Logbook Family of Forms
FORMS: NONE
OMB NO: 0648-0216 EXPIRATION DATE: 10/31/2004
RESPS:400 HOURS:43 COSTS(000):$0
Billfish Certificate of Eligibility
FORMS: NONE
OMB NO: 0648-0218 EXPIRATION DATE: 07/31/2004
RESPS:672 HOURS:430 COSTS(000):$73
South Pacific Tuna Act
FORMS: NONE
OMB NO: 0648-0223 EXPIRATION DATE: 03/31/2005
RESPS:400 HOURS:400 COSTS(000):$0
Pacific Albacore Logbook
FORMS: 88-197
OMB NO: 0648-0227 EXPIRATION DATE: 10/31/2004
RESPS:300 HOURS:50 COSTS(000):$0
NOAA Satelite Ground Station Customer Questionnaire
FORMS: NONE
OMB NO: 0648-0228 EXPIRATION DATE: 09/30/2005
RESPS:1 HOURS:1 COSTS(000):$0
U.S. Fisher men Fishing in Russian Waters
FORMS: NONE
OMB NO: 0648-0229 EXPIRATION DATE: 07/31/2005
RESPS:63,520 HOURS:3,451 COSTS(000):$15
Northeast Region Dealer Purchase Reports
FORMS: 88-30 88-142
OMB NO: 0648-0230 EXPIRATION DATE: 03/31/2005
RESPS:24 HOURS:1,048 COSTS(000):$1
Permits for Incidental Taking of Endangered or Threatened Species
FORMS: NONE
OMB NO: 0648-0238 EXPIRATION DATE: 09/30/2005
RESPS:618 HOURS:52 COSTS(000):$0
Surf Clam/Ocean Quahog Transfer Log
FORMS: NONE
OMB NO: 0648-0239 EXPIRATION DATE: 02/28/2006
RESPS:14,464 HOURS:526 COSTS(000):$1
Bluefin Tuna Dealer Reporting Package
FORMS: 88-144
OMB NO: 0648-0240 EXPIRATION DATE: 09/30/2005
RESPS:2 HOURS:1 COSTS(000):$0
Application to Shuck Surf Clams/Ocean Quahogs at Sea
FORMS: NONE
OMB NO: 0648-0243 EXPIRATION DATE: 04/30/2005
RESPS:40 HOURS:3 COSTS(000):$0
Survey of Intent and Capacity to Harvest and Process Fish and
Shellfish (Northwest Region)
FORMS: NONE
OMB NO: 0648-0247 EXPIRATION DATE: 04/30/2005
RESPS:12,000 HOURS:360 COSTS(000):$0
Cooperative Game Fish Tagging Report
FORMS: 88-162
OMB NO: 0648-0259 EXPIRATION DATE: 08/31/2004
RESPS:240 HOURS:8 COSTS(000):$0
Tag Recapture Card
FORMS: NONE
OMB NO: 0648-0262 EXPIRATION DATE: 12/31/2003
RESPS:4 HOURS:1 COSTS(000):$0
Informaiton for Share Transfer in Wreckfish Fishery
FORMS: NONE
OMB NO: 0648-0266 EXPIRATION DATE: 06/30/2005
RESPS:7,082 HOURS:13,065 COSTS(000):$3
Seafood Inspection and Certification Requirements
FORMS: 89-800 89-814 89-819
OMB NO: 0648-0269 EXPIRATION DATE: 10/31/2004
RESPS:8,157 HOURS:3,746 COSTS(000):$1
Western Alaska Community Development Quota Program
FORMS: NONE
OMB NO: 0648-0271 EXPIRATION DATE: 08/31/2003
RESPS:6,836 HOURS:1,705 COSTS(000):$10
Northwest Region Logbook Family of Forms
FORMS: NONE
OMB NO: 0648-0272 EXPIRATION DATE: 03/31/2005
RESPS:46,718 HOURS:13,249 COSTS(000):$82
Individual Fishing Quotas for Pacific Halibut and Sablefish in
the Alaska Fisheries
FORMS: NONE
OMB NO: 0648-0276 EXPIRATION DATE: 06/30/2003
RESPS:4,320 HOURS:346 COSTS(000):$0
Groundfish Tagging Program
FORMS: NONE
OMB NO: 0648-0283 EXPIRATION DATE: 03/31/2004
RESPS:420 HOURS:309 COSTS(000):$1
NOAA's Teacher-At-Sea Program
FORMS: NONE
OMB NO: 0648-0292 EXPIRATION DATE: 08/31/2003
RESPS:10,000 HOURS:1,500 COSTS(000):$0
Reporting Requirements for Commercial Fisheries Authorization
under Section 118 of the Marine Mammal Protection Act
FORMS: NONE
OMB NO: 0648-0293 EXPIRATION DATE: 08/31/2003
RESPS:6,750 HOURS:1,307 COSTS(000):$120
Application for Commercial Fisheries Authorization under Section
FORMS: NONE
OMB NO: 0648-0295 EXPIRATION DATE: 11/30/2004
RESPS:10,000 HOURS:2,500 COSTS(000):$3
Emergency Beacon Registrations
FORMS: NONE
OMB NO: 0648-0304 EXPIRATION DATE: 03/31/2005
RESPS:200 HOURS:100 COSTS(000):$10
High Seas Fishing Permit Application Information
FORMS: NONE
OMB NO: 0648-0308 EXPIRATION DATE: 12/31/2003
RESPS:1,575 HOURS:788 COSTS(000):$0
2002 NOAA Coastal Services Center Coastal Resource Management
Customer Survey
FORMS: NONE
OMB NO: 0648-0309 EXPIRATION DATE: 08/31/2005
RESPS:170 HOURS:695 COSTS(000):$0
Scientific Research, Exempted Fishing, and Exempted Activity
Submissions
FORMS: NONE
OMB NO: 0648-0311 EXPIRATION DATE: 12/31/2005
RESPS:93 HOURS:48 COSTS(000):$0
Report of Whaling Operations
FORMS: NONE
OMB NO: 0648-0314 EXPIRATION DATE: 05/31/2003
RESPS:54 HOURS:4,695 COSTS(000):$0
Designation of Fishery Management Council Members and
Application for Reinstatement of State Authority
FORMS: NONE
OMB NO: 0648-0316 EXPIRATION DATE: 03/31/2005
RESPS:6,841 HOURS:733 COSTS(000):$0
Prohibited Species Donation Program
FORMS: NONE
OMB NO: 0648-0318 EXPIRATION DATE: 11/30/2005
RESPS:3,998 HOURS:1,963 COSTS(000):$84
Observer Providers of the North Pacific
FORMS: NONE
OMB NO: 0648-0323 EXPIRATION DATE: 05/31/2003
RESPS:600 HOURS:110 COSTS(000):$0
Highly Migratory Species Tournament Reporting
FORMS: NONE
OMB NO: 0648-0327 EXPIRATION DATE: 06/30/2005
RESPS:23,359 HOURS:4,668 COSTS(000):$631
Atlantic Highly Migratory Species Vessel Permits
FORMS: NONE
OMB NO: 0648-0328 EXPIRATION DATE: 08/31/2003
RESPS:8,697 HOURS:955 COSTS(000):$0
Atlantic Bluefin Tuna Mandatory Catch Reporting
FORMS: NONE
OMB NO: 0648-0329 EXPIRATION DATE: 02/29/2004
RESPS:72 HOURS:36 COSTS(000):$0
Foreign Fishing Vessels Operating in Internal Waters
FORMS: NONE
OMB NO: 0648-0330 EXPIRATION DATE: 02/29/2004
RESPS:8,002 HOURS:3,508 COSTS(000):$6
At-Sea Scale Certification Program
FORMS: NONE
OMB NO: 0648-0334 EXPIRATION DATE: 12/31/2004
RESPS:244 HOURS:544 COSTS(000):$1
Alaska License Limitation Program for Groundfish, Crab, and
Scallops
FORMS: NONE
OMB NO: 0648-0335 EXPIRATION DATE: 03/31/2004
RESPS:4,000 HOURS:1,033 COSTS(000):$0
Fisheries Certificate of Origin
FORMS: NOAA-FORM-370
OMB NO: 0648-0338 EXPIRATION DATE: 10/31/2004
RESPS:25 HOURS:15 COSTS(000):$0
Implantation and Recovery of Archival Tags
FORMS: NONE
OMB NO: 0648-0342 EXPIRATION DATE: 07/31/2004
RESPS:70,000 HOURS:1,800 COSTS(000):$0
NOAA Customer Surveys
FORMS: NONE
OMB NO: 0648-0345 EXPIRATION DATE: 03/31/2005
RESPS:4,926 HOURS:7,500 COSTS(000):$338
Southeast Region Bycatch Reduction Device Certification Family
of Forms
FORMS: NONE
OMB NO: 0648-0346 EXPIRATION DATE: 09/30/2005
RESPS:20 HOURS:30 COSTS(000):$0
List of Gear by Fisheries and Fishery Management Council
FORMS: NONE
OMB NO: 0648-0348 EXPIRATION DATE: 03/31/2005
RESPS:50 HOURS:37 COSTS(000):$1
High Seas Fishing Vessel Identification Requirements
FORMS: NONE
OMB NO: 0648-0349 EXPIRATION DATE: 03/31/2005
RESPS:15,000 HOURS:850 COSTS(000):$2
High Seas Fishing Vessel Reporting Requirements
FORMS: NONE
OMB NO: 0648-0350 EXPIRATION DATE: 10/31/2004
RESPS:5,821 HOURS:4,363 COSTS(000):$58
Northeast Region Vessel Identification Requirements
FORMS: NONE
OMB NO: 0648-0351 EXPIRATION DATE: 10/31/2004
RESPS:1,950,283 HOURS:32,664 COSTS(000):$32
Northeast Region Gear Identification Requirements
FORMS: NONE
OMB NO: 0648-0352 EXPIRATION DATE: 04/30/2005
RESPS:12,317 HOURS:3,079 COSTS(000):$3
Northwest Region Gear Identification Requirements
FORMS: NONE
OMB NO: 0648-0353 EXPIRATION DATE: 07/31/2004
RESPS:15,000 HOURS:3,750 COSTS(000):$4
Alaska Region Gear Identification Requirements
FORMS: NONE
OMB NO: 0648-0354 EXPIRATION DATE: 03/31/2005
RESPS:1 HOURS:1 COSTS(000):$0
Foreign Fishing Gear Identification Requirements
FORMS: NONE
OMB NO: 0648-0355 EXPIRATION DATE: 03/31/2005
RESPS:1,984 HOURS:1,488 COSTS(000):$69
Northwest Region Vessel Identification Requirements
FORMS: NONE
OMB NO: 0648-0356 EXPIRATION DATE: 03/31/2005
RESPS:10 HOURS:8 COSTS(000):$0
Foreign Fishing Vessel Identification Requirements
FORMS: NONE
OMB NO: 0648-0357 EXPIRATION DATE: 09/30/2004
RESPS:1,225 HOURS:21 COSTS(000):$1
Gear-Marking Requirements for the Harbor Porpoise Take Reduction
Plan
FORMS: NONE
OMB NO: 0648-0358 EXPIRATION DATE: 04/30/2005
RESPS:7,000 HOURS:5,350 COSTS(000):$214
Southeast Region Vessel Identification Requirements
FORMS: NONE
OMB NO: 0648-0359 EXPIRATION DATE: 04/30/2005
RESPS:112,700 HOURS:2,192 COSTS(000):$15
Southeast Region Gear Identification Requirements
FORMS: NONE
OMB NO: 0648-0360 EXPIRATION DATE: 10/31/2004
RESPS:42,750 HOURS:1,425 COSTS(000):$23
Southwest Region Gear Identification Requirements
FORMS: NONE
OMB NO: 0648-0361 EXPIRATION DATE: 12/31/2004
RESPS:436 HOURS:286 COSTS(000):$7
Southwest Region Vessel Identification Requirements
FORMS: NONE
OMB NO: 0648-0362 EXPIRATION DATE: 09/30/2004
RESPS:1,611 HOURS:580 COSTS(000):$1
Sea Grant Program Application Requirements for Grants, for John
A. Knauss Marine Policy Fellowships, and for Designation as a
Sea Grant College or Regional Consortia
FORMS: 90-1 90-2 90-4
OMB NO: 0648-0363 EXPIRATION DATE: 12/31/2004
RESPS:5,700 HOURS:5,700 COSTS(000):$0
Swordfish Import Certificate of Eligibility
FORMS: NONE
OMB NO: 0648-0364 EXPIRATION DATE: 09/30/2005
RESPS:257,218 HOURS:2,572 COSTS(000):$27
Gear-Marking Requirements for Atlantic Large Whale Take
Reduction Plan
FORMS: NONE
OMB NO: 0648-0365 EXPIRATION DATE: 12/31/2005
RESPS:100 HOURS:50 COSTS(000):$0
Documentation of Fish Harvest
FORMS: NONE
OMB NO: 0648-0367 EXPIRATION DATE: 03/31/2005
RESPS:1 HOURS:10 COSTS(000):$0
Gear-Marking Requirements in Antarctic Fisheries
FORMS: NONE
OMB NO: 0648-0368 EXPIRATION DATE: 09/30/2005
RESPS:3 HOURS:2 COSTS(000):$0
Vessel-Marking Requirements in Antarctic Fisheries
FORMS: NONE
OMB NO: 0648-0369 EXPIRATION DATE: 12/31/2005
RESPS:2,278 HOURS:7,074 COSTS(000):$0
Economic Performance Data for West Coast (California-Alaska)
Commercial Fisheries
FORMS: NONE
OMB NO: 0648-0371 EXPIRATION DATE: 06/30/2005
RESPS:118,016 HOURS:24,295 COSTS(000):$59
Highly Migratory Species Vessel Logbooks and Cost-Earnings Data
Reports
FORMS: 88-191
OMB NO: 0648-0373 EXPIRATION DATE: 06/30/2005
RESPS:12,696 HOURS:7,199 COSTS(000):$161
Atlantic Highly Migratory Species Vessel and Gear Marking
FORMS: NONE
OMB NO: 0648-0374 EXPIRATION DATE: 06/30/2005
RESPS:8,936 HOURS:295 COSTS(000):$4
Atlantic Highly Migratory Species Observer Notification
Requirement
FORMS: NONE
OMB NO: 0648-0376 EXPIRATION DATE: 07/31/2005
RESPS:16,495 HOURS:38,563 COSTS(000):$2
Fishing Capacity Reduction Program Buyback Requests
FORMS: NONE
OMB NO: 0648-0384 EXPIRATION DATE: 10/31/2003
RESPS:1,000 HOURS:1,100 COSTS(000):$0
NOAA Coastal Ocean Program Grants Proposal Application Package
FORMS: NONE
OMB NO: 0648-0387 EXPIRATION DATE: 02/28/2006
RESPS:271 HOURS:144 COSTS(000):$1
International Dolphin Conservation Program
FORMS: NONE
OMB NO: 0648-0392 EXPIRATION DATE: 12/31/2005
RESPS:3,010 HOURS:251 COSTS(000):$0
Monitoring of Fish Trap Fishing in the Gulf of Mexico
FORMS: NONE
OMB NO: 0648-0393 EXPIRATION DATE: 09/30/2003
RESPS:141 HOURS:83 COSTS(000):$1
American Fisheries Act: Vessel and Processor Permit Applications
FORMS: NONE
OMB NO: 0648-0397 EXPIRATION DATE: 04/30/2003
RESPS:75 HOURS:75 COSTS(000):$0
Application Form for Membership on a National Marine Sanctuary
Advisory Council
FORMS: NONE
OMB NO: 0648-0398 EXPIRATION DATE: 04/30/2003
RESPS:4,425 HOURS:8,400 COSTS(000):$17
Alaska Individual Fishing Quota Cost Recovery Program
Requirements
FORMS: NONE
OMB NO: 0648-0400 EXPIRATION DATE: 06/30/2003
RESPS:2,847 HOURS:793 COSTS(000):$0
Commercial Harvesters and Recreational Party and Charter Boat
Socio-cultural and Economic Data Collection Pilot Study
FORMS: NONE
OMB NO: 0648-0401 EXPIRATION DATE: 12/31/2003
RESPS:1,365 HOURS:888 COSTS(000):$0
American Fisheries Act: Recordkeeping and Reporting Requirements
FORMS: NONE
OMB NO: 0648-0402 EXPIRATION DATE: 11/30/2005
RESPS:318 HOURS:6,310 COSTS(000):$4
Application and Reports for Scientific Research and Enhancement
Permits Under the Endangered Species Act
FORMS: NONE
OMB NO: 0648-0403 EXPIRATION DATE: 06/30/2003
RESPS:180 HOURS:68 COSTS(000):$1
Northeast Region Herring Permits
FORMS: NONE
OMB NO: 0648-0404 EXPIRATION DATE: 06/30/2003
RESPS:114,060 HOURS:185 COSTS(000):$67
Northeast Region Vessel Monitoring and Communications
FORMS: NONE
OMB NO: 0648-0405 EXPIRATION DATE: 06/30/2003
RESPS:50 HOURS:25 COSTS(000):$1
Atlantic Herring Processed Products Report
FORMS: NONE
OMB NO: 0648-0406 EXPIRATION DATE: 06/30/2003
RESPS:2,600 HOURS:87 COSTS(000):$3
Northeast Region Herring Dealer Landing Reports
FORMS: NONE
OMB NO: 0648-0407 EXPIRATION DATE: 06/30/2003
RESPS:2,653 HOURS:176 COSTS(000):$1
Atlantic Herring Vessel Trip Reports
FORMS: NONE
OMB NO: 0648-0408 EXPIRATION DATE: 06/30/2003
RESPS:665 HOURS:1,330 COSTS(000):$0
National Marine Sanctuaries - Socioeconomic Impacts of Marine
Reserves
FORMS: NONE
OMB NO: 0648-0409 EXPIRATION DATE: 07/31/2003
RESPS:988 HOURS:725 COSTS(000):$0
Socioeconomic Monitoring Program for the Florida Keys National
Marine Sanctuary
FORMS: NONE
OMB NO: 0648-0410 EXPIRATION DATE: 07/31/2003
RESPS:10,600 HOURS:2,733 COSTS(000):$0
South Florida Artificial and Natural Reefs - Economic Valuation
Study
FORMS: NONE
OMB NO: 0648-0411 EXPIRATION DATE: 07/31/2003
RESPS:4,111 HOURS:20,331 COSTS(000):$8,000
Paperwork Submissions Under the Coastal Zone Management Act
Federal Consistency Requirements
FORMS: NONE
OMB NO: 0648-0412 EXPIRATION DATE: 06/30/2003
RESPS:528 HOURS:18 COSTS(000):$0
Multispecies Pary/Charterboat Closed Area Exemption Certificate
FORMS: NONE
OMB NO: 0648-0413 EXPIRATION DATE: 02/29/2004
RESPS:800 HOURS:3,200 COSTS(000):$0
Fisheries Capacity Reduction Program Advanced Referenda and
Other Requirements
FORMS: NONE
OMB NO: 0648-0416 EXPIRATION DATE: 12/31/2003
RESPS:272,100 HOURS:2,950 COSTS(000):$195
Northeast Region Sea Scallop Exemption Requirements
FORMS: NONE
OMB NO: 0648-0417 EXPIRATION DATE: 08/31/2003
RESPS:18,144 HOURS:145 COSTS(000):$13
Atka Mackerel Fishery Vessel Monitoring System (VMS) Report
FORMS: NONE
OMB NO: 0648-0418 EXPIRATION DATE: 08/31/2003
RESPS:302 HOURS:24 COSTS(000):$0
Tortugas Access Permits
FORMS: NONE
OMB NO: 0648-0419 EXPIRATION DATE: 01/31/2004
RESPS:40 HOURS:40 COSTS(000):$0
StormReady Application Form
FORMS: NONE
OMB NO: 0648-0420 EXPIRATION DATE: 07/31/2003
RESPS:14 HOURS:31 COSTS(000):$0
Alaska Scallop License Limitation Program Application and
Transfer Forms
FORMS: NONE
OMB NO: 0648-0422 EXPIRATION DATE: 04/30/2005
RESPS:6,912 HOURS:230 COSTS(000):$2
Northeast Region Raised Footrope Trawal Exempted Fishery
FORMS: NONE
OMB NO: 0648-0423 EXPIRATION DATE: 12/31/2003
RESPS:41,410 HOURS:3,451 COSTS(000):$0
An Observer Program for Catcher Vessels in the Pacific Coast
Groundfish Fishery
FORMS: NONE
OMB NO: 0648-0424 EXPIRATION DATE: 02/29/2004
RESPS:207 HOURS:37 COSTS(000):$0
Northeast Region Lobster-Black Sea Bass Area 5 Waiver
Requirements
FORMS: NONE
OMB NO: 0648-0425 EXPIRATION DATE: 03/31/2004
RESPS:1,944,000 HOURS:3,600 COSTS(000):$225
AFA Pollock Fishery Vessel Monitoring System
FORMS: NONE
OMB NO: 0648-0427 EXPIRATION DATE: 03/31/2004
RESPS:100 HOURS:8 COSTS(000):$1
Hunger Relief Donation in the At-Sea Whiting Fishery
FORMS: NONE
OMB NO: 0648-0428 EXPIRATION DATE: 03/31/2004
RESPS:134 HOURS:1,072 COSTS(000):$0
Commercial Operator's Annual Report (COAR)
FORMS: NONE
OMB NO: 0648-0431 EXPIRATION DATE: 05/31/2004
RESPS:420 HOURS:564 COSTS(000):$2
Eastern Pacific Tuna Vessel Register Information
FORMS: NONE
OMB NO: 0648-0432 EXPIRATION DATE: 08/31/2004
RESPS:2,020 HOURS:3,517 COSTS(000):$3
Dr. Nancy Foster Scholarship Program
FORMS: CD-346
OMB NO: 0648-0433 EXPIRATION DATE: 09/30/2004
RESPS:40 HOURS:10 COSTS(000):$0
Reporting Requirements for the Ocean Salmon Fishery off the
Coasts of Washington, Oregon, and California
FORMS: NONE
OMB NO: 0648-0435 EXPIRATION DATE: 12/31/2005
RESPS:787 HOURS:316 COSTS(000):$0
Survey to Measure Effectiveness of Community-Oriented Policing
for ESA Enforcement
FORMS: NONE
OMB NO: 0648-0439 EXPIRATION DATE: 07/31/2004
RESPS:435 HOURS:154 COSTS(000):$0
North Carolina and Louisiana Commerical King and/or Spanish
Mackerel Fishermen Pilot Economic Survey
FORMS: NONE
OMB NO: 0648-0440 EXPIRATION DATE: 04/30/2005
RESPS:430 HOURS:2,150 COSTS(000):$4
Coastal Impact Assistance Program: Project Review Checklist
FORMS: NONE
OMB NO: 0648-0441 EXPIRATION DATE: 07/31/2004
RESPS:1,445,568 HOURS:743 COSTS(000):$0
Vessel Monitoring System Requirements in the Western Pacific
Pelagic Longline Fishery
FORMS: NONE
OMB NO: 0648-0442 EXPIRATION DATE: 08/31/2004
RESPS:175 HOURS:44 COSTS(000):$0
Observer Workshop/Conference Survey
FORMS: NONE
OMB NO: 0648-0445 EXPIRATION DATE: 07/31/2005
RESPS:6,986,518 HOURS:13,152 COSTS(000):$491
NMFS Alaska Region Vessel Monitoring System (VMS) Program
FORMS: NONE
OMB NO: 0648-0446 EXPIRATION DATE: 03/31/2005
RESPS:1,002 HOURS:85 COSTS(000):$0
Atlantic Billfish and Swordfish Recreational Landings Call-in
Report
FORMS: NONE
OMB NO: 0648-0447 EXPIRATION DATE: 04/30/2005
RESPS:4,160 HOURS:1,048 COSTS(000):$0
Alaska Marine Sport Fishing Economics Survey
FORMS: NONE
OMB NO: 0648-0448 EXPIRATION DATE: 03/31/2005
RESPS:78 HOURS:78 COSTS(000):$2
Coral Reef Conservation Program Administration
FORMS: NONE
OMB NO: 0648-0449 EXPIRATION DATE: 03/31/2005
RESPS:1,000 HOURS:5,000 COSTS(000):$0
Data Collection on Marine Protected and Managed Areas
FORMS: NONE
OMB NO: 0648-0450 EXPIRATION DATE: 03/31/2005
RESPS:2,041 HOURS:1,097 COSTS(000):$8
American Lobster Requirements for Historical Participation in
Areas 3, 4, and 5
FORMS: NONE
OMB NO: 0648-0451 EXPIRATION DATE: 05/31/2005
RESPS:3,100 HOURS:2,200 COSTS(000):$199
Southeast Region Reef Fish/Coastal Migratory Pelagic Charter
Vessel Permit Issuance
FORMS: NONE
OMB NO: 0648-0452 EXPIRATION DATE: 06/30/2005
RESPS:24 HOURS:2 COSTS(000):$0
Atlantic Highly Migratory Species Protected Species Interaction
Report
FORMS: NONE
OMB NO: 0648-0456 EXPIRATION DATE: 07/31/2005
RESPS:6 HOURS:5 COSTS(000):$0
Southwest Region Seabird-Fisheries Interaction Recovery Reporting
FORMS: NONE
OMB NO: 0648-0458 EXPIRATION DATE: 07/31/2005
RESPS:35 HOURS:55 COSTS(000):$7
Southeast Region Stone Crab Vessel Permit Issuance Under the New
Trap Limitation Program
FORMS: NONE
OMB NO: 0648-0459 EXPIRATION DATE: 04/30/2003
RESPS:84 HOURS:1,520 COSTS(000):$1
Coastal and Estuarine Land Conservation, Planning, Protection,
or Restoration
FORMS: NONE
OMB NO: 0648-0460 EXPIRATION DATE: 12/31/2003
RESPS:15,058 HOURS:5,617 COSTS(000):$26
Subsistence Fishery for Pacific Halibut in Waters Off Alaska
FORMS: NONE
OMB NO: 0648-0461 EXPIRATION DATE: 11/30/2005
RESPS:34,151 HOURS:9,029 COSTS(000):$351
South Atlantic Rock Shrimp Vessel Permits and Monitoring
FORMS: NONE
OMB NO: 0648-0462 EXPIRATION DATE: 11/30/2005
RESPS:815 HOURS:382 COSTS(000):$0
Southwest Region Coral Reef Ecosystems Logbook and Reporting
FORMS: NONE
OMB NO: 0648-0463 EXPIRATION DATE: 11/30/2005
RESPS:14 HOURS:30 COSTS(000):$0
Southwest Region Coral Reef Ecosystems Permit Form
FORMS: NONE
OMB NO: 0648-0464 EXPIRATION DATE: 12/31/2005
RESPS:100 HOURS:150 COSTS(000):$0
Economic Data Collection for the Trap Fishery in the U.S.
Caribbean
FORMS: NONE
OMB NO: 0648-0465 EXPIRATION DATE: 04/30/2003
RESPS:954 HOURS:308 COSTS(000):$0
Revisions to American Lobster Requirements for Historical
Participation in Areas 3, 4, and 5.
FORMS: NONE
OMB NO: 0648-0466 EXPIRATION DATE: 12/31/2005
RESPS:5 HOURS:3,300 COSTS(000):$0
Submission of Conservation Efforts to Make Listings Unnecessary
under the Endangered Species Act
FORMS: NONE
OMB NO: 0648-0467 EXPIRATION DATE: 12/31/2003
RESPS:3,940 HOURS:657 COSTS(000):$0
Southeast Region Electronic Reporting Survey
FORMS: NONE
OMB NO: 0648-0468 EXPIRATION DATE: 02/28/2006
RESPS:20 HOURS:40 COSTS(000):$0
Protocol for Access to Tissue Specimen Samples from the National
Marine Mammal Tissue Bank
FORMS: NONE
OMB NO: 0648-0469 EXPIRATION DATE: 02/28/2006
RESPS:144 HOURS:5 COSTS(000):$0
Scup Gear Restricted Area (GRA) Access Program Exemption
Authorization
FORMS: NONE
OMB NO: 0648-0470 EXPIRATION DATE: 02/28/2006
RESPS:441 HOURS:74 COSTS(000):$1
Reporting of Sea Turtle Incidental Take in Virginia Chesapeake
Bay Pound Net Operations
FORMS: NONE
OMB NO: 0648-0471 EXPIRATION DATE: 02/28/2006
RESPS:1,040 HOURS:141 COSTS(000):$6
Highly Migratory Species Scientific Research Permits, Exempted
Fishing Permits, and Letters of Authorization
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
169 16,592,543 560,503 $16,297
Patent and Trademark Office
OMB NO: 0651-0009 EXPIRATION DATE: 06/30/2005
RESPS:677,151 HOURS:144,587 COSTS(000):$147,135
TRADEMARK PROCESSING (Proposed rulemaking, Processing Fee for
Use of Paper Forms for Submission of Applications for
Registration and Other Documents)
FORMS: 4.8/4.9/4.16 1478(A) 1553 1581 1583 1963 2000 PTOTM/4.16/1583
OMB NO: 0651-0012 EXPIRATION DATE: 04/30/2003
RESPS:15,200 HOURS:6,138 COSTS(000):$0
Admittance To Practice and Roster of Registered Patent Attorneys
Office
FORMS: PTO-158 PTO-158A PTO-275 PTO-107A
OMB NO: 0651-0016 EXPIRATION DATE: 04/30/2003
RESPS:279,796 HOURS:22,340 COSTS(000):$0
Rules for Patent Maintenance Fees
FORMS: PTO/SB/45/47/ 65/66
OMB NO: 0651-0017 EXPIRATION DATE: 07/31/2003
RESPS:330 HOURS:2,270 COSTS(000):$0
Practitioner records maintenance and disclosure before the
patent and trademark office
FORMS: NONE
OMB NO: 0651-0020 EXPIRATION DATE: 10/31/2004
RESPS:26,858 HOURS:30,903 COSTS(000):$5,976
Patent Term Extension
FORMS: NONE
OMB NO: 0651-0021 EXPIRATION DATE: 12/31/2003
RESPS:331,407 HOURS:401,202 COSTS(000):$78,889,386
Patent Cooperation Treaty
FORMS: RO/101/134/144 PTO/1382 PCT/IPEA/401 PCT/IB/328
OMB NO: 0651-0022 EXPIRATION DATE: 01/31/2004
RESPS:3,300 HOURS:3,301 COSTS(000):$1
Deposit of Biological Materials
FORMS: NONE
OMB NO: 0651-0024 EXPIRATION DATE: 08/31/2003
RESPS:6,060 HOURS:7,990 COSTS(000):$0
Requirements for Patent Applications Containing Nucelotide
FORMS: NONE
OMB NO: 0651-0027 EXPIRATION DATE: 06/30/2005
RESPS:298,133 HOURS:149,067 COSTS(000):$12,470
Recording Assignments
FORMS: 1594 1595
OMB NO: 0651-0028 EXPIRATION DATE: 04/30/2003
RESPS:80 HOURS:14 COSTS(000):$0
Fastener Quality Act Insignia Recordal Process
FORMS: PTO-1611
OMB NO: 0651-0030 EXPIRATION DATE: 03/31/2005
RESPS:20,250 HOURS:4,050 COSTS(000):$203
Disclosure Document Program
FORMS: PTO/SB/95
OMB NO: 0651-0031 EXPIRATION DATE: 04/30/2003
RESPS:2,247,270 HOURS:1,021,822 COSTS(000):$15,251
Patent Processing (Updating)
FORMS: PTO/SB/08A/08B 21/22/23/24/25 26/27/30/31/35 36/42/43/61
61/PCT/62/63/64 64PCT/67/68/91 92/96/97 PTO/SB/32/37
PTO-2053-A/B PTO-2054-A/B
OMB NO: 0651-0032 EXPIRATION DATE: 04/30/2003
RESPS:319,350 HOURS:2,984,360 COSTS(000):$75,095
Intial Patent Application
FORMS: PTO/SB/01/01A 02A/02B/02C/03 03A/04/05/06/07 13PCT/17/18/19
29/29A/101/102/ 103/104/105/106 107/108/109/110
OMB NO: 0651-0033 EXPIRATION DATE: 01/31/2004
RESPS:205,480 HOURS:63,640 COSTS(000):$1,540
Post Allowance and Refiling
FORMS: PTO/SB/44/50/51 51S/52/53/55/56 57/58 PTOL-85B
OMB NO: 0651-0034 EXPIRATION DATE: 03/31/2004
RESPS:2,194 HOURS:1,523 COSTS(000):$0
Secrecy, License to export
FORMS: NONE
OMB NO: 0651-0035 EXPIRATION DATE: 11/30/2005
RESPS:338,280 HOURS:31,259 COSTS(000):$170
Representative and Address Provisions
FORMS: PTO/SB/81 PTO/SB/82 PTO/SB/83 PTO/SB/121 PTO/SB/122 PTO/SB/123
PTO/SB/124A PTO/SB/124B PTP/SB/125A PTO/SB/125B
OMB NO: 0651-0036 EXPIRATION DATE: 04/30/2003
RESPS:73 HOURS:29 COSTS(000):$0
Statutory Invention Registration
FORMS: PTO-SB-94
OMB NO: 0651-0040 EXPIRATION DATE: 05/31/2004
RESPS:42,400 HOURS:11,500 COSTS(000):$3,471
Trademark Trail and Appeal Board (TTAB) Actions (formerly
PETITION TO CANCEL)
FORMS: NONE
OMB NO: 0651-0041 EXPIRATION DATE: 06/30/2005
RESPS:11,928 HOURS:1,397 COSTS(000):$4
Public User ID Badging (formerly Public Search Room Badging)
FORMS: PTO-2030
OMB NO: 0651-0042 EXPIRATION DATE: 09/30/2005
RESPS:5,000 HOURS:2,500 COSTS(000):$2
Electronic Application for Patent Examiners-Job Application
Rating System (JARS)
FORMS: PTO_2041
OMB NO: 0651-0043 EXPIRATION DATE: 02/28/2006
RESPS:327,308 HOURS:29,497 COSTS(000):$8
Payment of Patent and Trademark Office Fees by Credit Card
FORMS: PTO-2038
OMB NO: 0651-0044 EXPIRATION DATE: 09/30/2003
RESPS:100 HOURS:26 COSTS(000):$0
Invention Promoters/Promotion Firms Complaints
FORMS: PTO/SB/2048
OMB NO: 0651-0045 EXPIRATION DATE: 04/30/2003
RESPS:10,000 HOURS:5,000 COSTS(000):$0
Public Key Infrastructure (PK) Certificate Action Form
FORMS: PTO-2042
OMB NO: 0651-0046 EXPIRATION DATE: 03/31/2004
RESPS:187 HOURS:28 COSTS(000):$650
Legal Processes
FORMS: NONE
OMB NO: 0651-0047 EXPIRATION DATE: 03/31/2004
RESPS:100 HOURS:150 COSTS(000):$0
Required and Optional Search Criteria for Computer Implemented
Business Method Patent Applications in Class 705
FORMS: NONE
OMB NO: 0651-0048 EXPIRATION DATE: 03/31/2005
RESPS:400 HOURS:74 COSTS(000):$0
Native American Tribal Insignai Database
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
26 5,168,635 4,924,667 $79,151,362
National Telecommunications and Information Administration
OMB NO: 0660-0001 EXPIRATION DATE: 05/31/2003
RESPS:1,966 HOURS:7,836 COSTS(000):$0
Public Telecommunications Facilities Program Grant Monitoring
FORMS: NONE
OMB NO: 0660-0003 EXPIRATION DATE: 10/31/2003
RESPS:450 HOURS:40,250 COSTS(000):$0
Public Telecommunications Facilities Program (PTFP) Application
Form
FORMS: NONE
OMB NO: 0660-0010 EXPIRATION DATE: 04/30/2005
RESPS:252 HOURS:42 COSTS(000):$0
Technology Opportunities Program (TOP) Review Information Form
FORMS: NONE
OMB NO: 0660-0013 EXPIRATION DATE: 04/30/2005
RESPS:210 HOURS:210 COSTS(000):$0
Technology Opportunities Program (TOP) Grant Recipient Survey
FORMS: NONE
OMB NO: 0660-0015 EXPIRATION DATE: 03/31/2005
RESPS:50 HOURS:1,492 COSTS(000):$0
Performance Reorting System (PRS) for the Technology
Opportunities Program (TOP)
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
5 2,928 49,830 $0
Office of the Secretary
OMB NO: 0690-0018 EXPIRATION DATE: 02/29/2004
RESPS:33,750 HOURS:2,812 COSTS(000):$0
Applicant Background Survey
FORMS: NONE
OMB NO: 0690-0019 EXPIRATION DATE: 08/31/2004
RESPS:32,832 HOURS:32,832 COSTS(000):$0
Commerce Opportunity On-Line
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
2 66,582 35,644 $0
Bureau of Economic Analysis
OMB NO: 0691-0001 EXPIRATION DATE: 07/31/2003
RESPS:7,500 HOURS:1,875 COSTS(000):$0
BEA Customer Satisfaction Survey
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
1 7,500 1,875 $0
Technology Administration
OMB NO: 0692-0001 EXPIRATION DATE: 12/31/2005
RESPS:105 HOURS:2,625 COSTS(000):$0
National Medal of Technology Nomination Application
FORMS: NONE
OMB NO: 0692-0006 EXPIRATION DATE: 06/30/2003
RESPS:1,900 HOURS:1,200 COSTS(000):$0
Licensing of Government-owned Inventions
FORMS: NONE
OMB NO: 0692-0009 EXPIRATION DATE: 04/30/2003
RESPS:7 HOURS:70 COSTS(000):$0
Commercial Space Launch Range User Requirements
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
3 2,012 3,895 $0
National Institute of Standards and Technology
OMB NO: 0693-0003 EXPIRATION DATE: 12/31/2003
RESPS:800 HOURS:2,200 COSTS(000):$0
National Voluntary Laboratory Accreditation Program (NVLAP),
NVLAP Information Collection System
FORMS: NONE
OMB NO: 0693-0006 EXPIRATION DATE: 10/31/2003
RESPS:100 HOURS:10,000 COSTS(000):$0
Malcolm Baldrige National Quality Award Application
FORMS: NONE
OMB NO: 0693-0009 EXPIRATION DATE: 12/31/2003
RESPS:1,000 HOURS:14,875 COSTS(000):$60
Advanced Technology Program
FORMS: NIST-1262 NIST-1263
OMB NO: 0693-0019 EXPIRATION DATE: 08/31/2005
RESPS:10 HOURS:30 COSTS(000):$0
National Voluntary Conformity Assessment System Evaluation
(NVCASE) Program
FORMS: NONE
OMB NO: 0693-0021 EXPIRATION DATE: 09/30/2005
RESPS:6,500 HOURS:1,083 COSTS(000):$0
Manufacturing Extension Partnership (MEP) Client Impact Surveys
FORMS: NONE
OMB NO: 0693-0031 EXPIRATION DATE: 12/31/2005
RESPS:6,000 HOURS:3,500 COSTS(000):$0
National Institute of Standards and Technology Three-Year
Generic Request for Customer Service-Related Data Collection
FORMS: NONE
OMB NO: 0693-0034 EXPIRATION DATE: 05/31/2003
RESPS:30 HOURS:120 COSTS(000):$0
Evaluation of the Common Industry Format (CIF) for Reporting the
Results of Usability Tests
FORMS: NONE
OMB NO: 0693-0035 EXPIRATION DATE: 05/31/2003
RESPS:1,440 HOURS:120 COSTS(000):$0
User Evaluation of DARPA Communicator systems
FORMS: NONE
OMB NO: 0693-0036 EXPIRATION DATE: 08/31/2004
RESPS:30 HOURS:1,875 COSTS(000):$6
BEES Please
FORMS: NONE
OMB NO: 0693-0037 EXPIRATION DATE: 10/31/2005
RESPS:240 HOURS:100 COSTS(000):$0
IRI/NIST Joint Study of Investment Decision Tools
FORMS: NONE
OMB NO: 0693-0038 EXPIRATION DATE: 12/31/2005
RESPS:79 HOURS:396 COSTS(000):$0
National Weights and Measures Benchmarking and Needs Assessment
FORMS: NONE
OMB NO: 0693-0040 EXPIRATION DATE: 03/31/2006
RESPS:547 HOURS:228 COSTS(000):$0
Survey of Advanced Technology Program Joint Venture Participants
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
12 16,776 34,527 $66
Bureau of Industry and Security
OMB NO: 0694-0001 EXPIRATION DATE: 12/31/2003
RESPS:21 HOURS:11 COSTS(000):$0
Exception to Reporting Requirements under the IC/DV Procedures
FORMS: NONE
OMB NO: 0694-0004 EXPIRATION DATE: 10/31/2004
RESPS:2 HOURS:510 COSTS(000):$0
Foreign Availability Procedures and Criteria
FORMS: NONE
OMB NO: 0694-0009 EXPIRATION DATE: 10/31/2004
RESPS:1 HOURS:1 COSTS(000):$0
Approval of Triangular Transactions Involving Commodities
Covered By A U.S. Import Certificate
FORMS: NONE
OMB NO: 0694-0012 EXPIRATION DATE: 07/31/2004
RESPS:1,177 HOURS:1,298 COSTS(000):$0
Report of Requests for Restrictive Trade Practice or Boycott--
Single or Multiple Transactions
FORMS: BXA-621P BXA-6051P
OMB NO: 0694-0013 EXPIRATION DATE: 03/31/2005
RESPS:80 HOURS:43 COSTS(000):$0
Computers and Related Equipment
FORMS: NONE
OMB NO: 0694-0016 EXPIRATION DATE: 08/31/2004
RESPS:100 HOURS:31 COSTS(000):$0
Delivery Vertification Procedure
FORMS: BXA-647P
OMB NO: 0694-0017 EXPIRATION DATE: 05/31/2004
RESPS:585 HOURS:156 COSTS(000):$0
International Import Certificate
FORMS: FORM-BXA-645P
OMB NO: 0694-0021 EXPIRATION DATE: 02/28/2006
RESPS:3,594 HOURS:959 COSTS(000):$0
Statement by Ultimate Consignee and Purchaser
FORMS: 711
OMB NO: 0694-0023 EXPIRATION DATE: 08/31/2004
RESPS:200 HOURS:104 COSTS(000):$0
Written Assurances for Exports of Technical Data Under License
Exception TSR
FORMS: NONE
OMB NO: 0694-0025 EXPIRATION DATE: 04/30/2004
RESPS:35 HOURS:35 COSTS(000):$0
Short Supply Regulations - Unprocessed Western Red Cedar
FORMS: NONE
OMB NO: 0694-0026 EXPIRATION DATE: 04/30/2005
RESPS:1 HOURS:1 COSTS(000):$0
Short Supply Regulations, Petroleum Products
FORMS: NONE
OMB NO: 0694-0027 EXPIRATION DATE: 05/31/2004
RESPS:15 HOURS:104 COSTS(000):$0
Short Supply Regulations, Petroleum (Crude Oil)
FORMS: NONE
OMB NO: 0694-0029 EXPIRATION DATE: 12/31/2003
RESPS:3 HOURS:1 COSTS(000):$0
License Exception TMP: Special Requirements
FORMS: NONE
OMB NO: 0694-0031 EXPIRATION DATE: 12/31/2003
RESPS:100 HOURS:27 COSTS(000):$0
Application for a Duplicate License
FORMS: NONE
OMB NO: 0694-0033 EXPIRATION DATE: 05/31/2004
RESPS:10 HOURS:10 COSTS(000):$0
License Exception, Humanitarian Donations
FORMS: NONE
OMB NO: 0694-0047 EXPIRATION DATE: 03/31/2005
RESPS:2,896 HOURS:3,602 COSTS(000):$0
Technology Letter of Explanation
FORMS: NONE
OMB NO: 0694-0051 EXPIRATION DATE: 07/31/2004
RESPS:10 HOURS:11 COSTS(000):$0
Application for Transfer of License to Another Party
FORMS: NONE
OMB NO: 0694-0053 EXPIRATION DATE: 12/31/2003
RESPS:707,000 HOURS:14,477 COSTS(000):$0
Defense Priorities and Allocations System
FORMS: NONE
OMB NO: 0694-0057 EXPIRATION DATE: 03/31/2004
RESPS:1,200 HOURS:600 COSTS(000):$0
Request for Special Priorities Assistance
FORMS: BXA-999
OMB NO: 0694-0058 EXPIRATION DATE: 08/31/2004
RESPS:80 HOURS:800 COSTS(000):$0
Procedure for Voluntary Self-Disclosure of Violations of the
Export Administration Regulations
FORMS: NONE
OMB NO: 0694-0073 EXPIRATION DATE: 05/31/2005
RESPS:22 HOURS:78 COSTS(000):$0
Export Controls of High Performance Computers
FORMS: NONE
OMB NO: 0694-0083 EXPIRATION DATE: 06/30/2005
RESPS:3,000 HOURS:1,500 COSTS(000):$0
Competitive Enhancement Needs Assessment Survey Program
FORMS: NONE
OMB NO: 0694-0084 EXPIRATION DATE: 12/31/2005
RESPS:100 HOURS:1,000 COSTS(000):$0
Military Exports
FORMS: NONE
OMB NO: 0694-0086 EXPIRATION DATE: 06/30/2003
RESPS:160 HOURS:23 COSTS(000):$0
Report of Sample Shipments of Chemical Weapon Recursors
FORMS: NONE
OMB NO: 0694-0088 EXPIRATION DATE: 04/30/2005
RESPS:14,191 HOURS:12,777 COSTS(000):$105
Multipurpose Application
FORMS: BXA-748P
OMB NO: 0694-0089 EXPIRATION DATE: 07/31/2004
RESPS:867 HOURS:1,017 COSTS(000):$0
Special Comprehensive License
FORMS: BXA-748P BXA-752P
OMB NO: 0694-0091 EXPIRATION DATE: 04/30/2003
RESPS:792 HOURS:27,020 COSTS(000):$43,732
Chemical Weapons Convention Declaration Forms, Inspections and
FORMS: FORM1-1 FORM1-2 FORM1-2A FORM1-2B FORM1-4 FORM-A FORM-B FORM2-1
FORM2-2
OMB NO: 0694-0092 EXPIRATION DATE: 10/31/2004
RESPS:700,000 HOURS:21,963 COSTS(000):$0
Procedures for Acceptance or Rejection of Rated Order
FORMS: NONE
OMB NO: 0694-0093 EXPIRATION DATE: 04/30/2005
RESPS:6,900 HOURS:1,957 COSTS(000):$0
Import Certificates and End-User Certificates
FORMS: NONE
OMB NO: 0694-0096 EXPIRATION DATE: 10/31/2004
RESPS:201,177 HOURS:249 COSTS(000):$0
Five Year Records Retention Period
FORMS: NONE
OMB NO: 0694-0100 EXPIRATION DATE: 09/30/2005
RESPS:1 HOURS:5 COSTS(000):$0
For the Appointment of a Technical Advisory Committee
FORMS: NONE
OMB NO: 0694-0101 EXPIRATION DATE: 05/31/2004
RESPS:35 HOURS:875 COSTS(000):$0
One-time Report For Foreign Software or Technology Eligible For
De Minimis Exclusion
FORMS: NONE
OMB NO: 0694-0102 EXPIRATION DATE: 09/30/2005
RESPS:2 HOURS:10 COSTS(000):$0
Miscellaneous Activities
FORMS: NONE
OMB NO: 0694-0104 EXPIRATION DATE: 04/30/2003
RESPS:234 HOURS:1,372 COSTS(000):$0
Commercial Encryption Items under the Jurisdiction of the
FORMS: BXA-748P
OMB NO: 0694-0106 EXPIRATION DATE: 07/31/2004
RESPS:3,050 HOURS:559 COSTS(000):$0
Reporting and Recordkeeping Requirements under the Wassenaar
Arrangement
FORMS: NONE
OMB NO: 0694-0107 EXPIRATION DATE: 03/31/2005
RESPS:140 HOURS:35 COSTS(000):$0
National Defense Authorization Act
FORMS: BXA-742R BXA-742S
OMB NO: 0694-0114 EXPIRATION DATE: 02/28/2006
RESPS:1,100 HOURS:550 COSTS(000):$0
Firearms Convention
FORMS: BXA-748P
OMB NO: 0694-0117 EXPIRATION DATE: 04/30/2003
RESPS:356 HOURS:176 COSTS(000):$0
Chemical Weapons Convention, Amendment to the Export
Administration Regulation (End-Use Certificates and Advance
Notifications and Annual Reports)
FORMS: NONE
OMB NO: 0694-0119 EXPIRATION DATE: 09/30/2005
RESPS:6,000 HOURS:24,000 COSTS(000):$0
National Security and Critical Technology Assessments of the US
Industrial Base
FORMS: NONE
OMB NO: 0694-0120 EXPIRATION DATE: 12/31/2005
RESPS:1 HOURS:3,000 COSTS(000):$0
Procedure to initiate an Investigation Under the Trade Expansion
Act of 1962
FORMS: NONE
OMB NO: 0694-0122 EXPIRATION DATE: 12/31/2005
RESPS:1,427,450 HOURS:70,104 COSTS(000):$0
Licensing Responsibilities and Equipment
FORMS: NONE
OMB NO: 0694-0123 EXPIRATION DATE: 03/31/2005
RESPS:100 HOURS:93 COSTS(000):$0
Prior Notification of Exports Under License Exception AGR
FORMS: BXA-748P
OMB NO: 0694-0125 EXPIRATION DATE: 09/30/2003
RESPS:3,900 HOURS:650 COSTS(000):$0
BIS Program Evaluation
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
43 3,086,688 191,794 $43,837
AGENCY TOTALS:
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
390 58,802,663 17,610,334 $79,213,010
Department of Defense
Department of the Air Force
OMB NO: 0701-0001 EXPIRATION DATE: 10/31/2003
RESPS:2,900 HOURS:8,700 COSTS(000):$0
Application for Training Leading to a Commission in the United
States Air Force
FORMS: AF-56
OMB NO: 0701-0026 EXPIRATION DATE: 09/30/2004
RESPS:16,200 HOURS:8,100 COSTS(000):$0
Nomination for Appointment to the United States Military
Academy, Naval Academy, and Air Force Academy
FORMS: DD-1870
OMB NO: 0701-0050 EXPIRATION DATE: 02/29/2004
RESPS:3,600 HOURS:1,800 COSTS(000):$0
Civil Aircraft Landing Permit System
FORMS: DD-2400 DD-2401 DD-2402
OMB NO: 0701-0063 EXPIRATION DATE: 01/31/2004
RESPS:7,010 HOURS:5,258 COSTS(000):$0
Air Force Academy Candidate Activities Record
FORMS: USAF-147
OMB NO: 0701-0064 EXPIRATION DATE: 01/31/2004
RESPS:7,233 HOURS:3,617 COSTS(000):$0
Air Force Academy Candidate Personal Data Record
FORMS: USAFA-146
OMB NO: 0701-0066 EXPIRATION DATE: 02/29/2004
RESPS:6,954 HOURS:3,477 COSTS(000):$0
Air Force Academy Request for Secondary School Transcript
FORMS: USAFA-148
OMB NO: 0701-0070 EXPIRATION DATE: 01/31/2004
RESPS:30,000 HOURS:2,666 COSTS(000):$0
Family Support Center Information
FORMS: AIR-FORCE-2800 AIR-FORCE-2801 AIR-FORCE-2805
OMB NO: 0701-0078 EXPIRATION DATE: 01/31/2004
RESPS:3,600 HOURS:3,600 COSTS(000):$0
Health Professions Accessions Forms
FORMS: AETC-1402 AETC-1437
OMB NO: 0701-0079 EXPIRATION DATE: 12/31/2003
RESPS:110,231 HOURS:69,105 COSTS(000):$0
Non-Prior Service and Prior Service Accessions
FORMS: AETC-1319 AETC-1325 AETC-1419
OMB NO: 0701-0080 EXPIRATION DATE: 01/31/2004
RESPS:1,200 HOURS:1,500 COSTS(000):$0
Air Force Officer Training School (OTS) Accession Forms
FORMS: AETC-1413 AETC-1422
OMB NO: 0701-0087 EXPIRATION DATE: 03/31/2005
RESPS:9,850 HOURS:3,940 COSTS(000):$0
United States Air Force Academy Application
FORMS: USAFA-149
OMB NO: 0701-0096 EXPIRATION DATE: 11/30/2004
RESPS:5,899 HOURS:1,966 COSTS(000):$0
Application for Appointment as Reserve of the Air Force or USAF
Without Component
FORMS: AF-24
OMB NO: 0701-0101 EXPIRATION DATE: 05/31/2004
RESPS:8,000 HOURS:4,000 COSTS(000):$0
Air Force ROTC College Scholarship Application
FORMS: AF-113
OMB NO: 0701-0103 EXPIRATION DATE: 04/30/2004
RESPS:500 HOURS:350 COSTS(000):$0
Air Force ROTC Scholarship Nomination
FORMS: AFOATS-36
OMB NO: 0701-0105 EXPIRATION DATE: 04/30/2004
RESPS:12,000 HOURS:4,000 COSTS(000):$0
Application for Air Force ROTC Membership
FORMS: AFOATS-20
OMB NO: 0701-0114 EXPIRATION DATE: 04/30/2004
RESPS:40 HOURS:20 COSTS(000):$0
Application for Establishment of Air Force Junior ROTC Unit
FORMS: AFOATS-59
OMB NO: 0701-0127 EXPIRATION DATE: 08/31/2003
RESPS:255 HOURS:64 COSTS(000):$0
USAF Museum System Volunteer Application/Registration
FORMS: AF-3569
OMB NO: 0701-0134 EXPIRATION DATE: 07/31/2004
RESPS:144 HOURS:144 COSTS(000):$0
Request for Approval of Foreign Government Employment of Air
Force Members
FORMS: NONE
OMB NO: 0701-0136 EXPIRATION DATE: 08/31/2005
RESPS:500 HOURS:167 COSTS(000):$0
Community College of the Air Force Alumni Survey
FORMS: NONE
OMB NO: 0701-0137 EXPIRATION DATE: 04/30/2003
RESPS:15 HOURS:300 COSTS(000):$0
Commercial Airlift Review
FORMS: AMC-207
OMB NO: 0701-0141 EXPIRATION DATE: 06/30/2004
RESPS:4,000 HOURS:1,000 COSTS(000):$0
Intercontinental Ballistic Missile Hardened Intersite Cable
System Right-of-Way Landowner/Tenant Questionnaire
FORMS: AF-3951
OMB NO: 0701-0146 EXPIRATION DATE: 07/31/2004
RESPS:200 HOURS:17 COSTS(000):$0
Customer Comment Card, Air Force Form 3211
FORMS: 3211
OMB NO: 0701-0147 EXPIRATION DATE: 05/31/2003
RESPS:4,100 HOURS:4,100 COSTS(000):$0
USAF Academy Candidate Writing Sample
FORMS: USAFA-0878
OMB NO: 0701-0149 EXPIRATION DATE: 03/31/2005
RESPS:441 HOURS:110 COSTS(000):$0
Air Force Research Laboratory Public Awareness Survey
FORMS: NONE
OMB NO: 0701-0150 EXPIRATION DATE: 10/31/2005
RESPS:1,300,000 HOURS:1,386,413 COSTS(000):$0
Air Force Recruiting Information Support System (AFRISS)
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
25 1,534,872 1,514,414 $0
Department of the Army
OMB NO: 0702-0018 EXPIRATION DATE: 10/31/2003
RESPS:6,320 HOURS:3,160 COSTS(000):$0
Uniform Tender of Rates and/or Charges for Domestic
Transportation Services (DoD/USCG Sponsored Household Goods)
FORMS: MT-HQ-FORM-43-R
OMB NO: 0702-0021 EXPIRATION DATE: 07/31/2005
RESPS:70 HOURS:70 COSTS(000):$0
Application and Contract for Establishment of a Junior Reserve
Officers' Training Corps United
FORMS: DA-FORM-3126
OMB NO: 0702-0022 EXPIRATION DATE: 10/31/2003
RESPS:441,677 HOURS:70,548 COSTS(000):$0
Tender of Service and Letter of Intent for Personal Property
Household Goods and Unaccompanied Baggage Shipments
FORMS: DD-FORM-619 DD-FORM-619-1
OMB NO: 0702-0027 EXPIRATION DATE: 01/31/2006
RESPS:75,000 HOURS:3,750 COSTS(000):$0
Signature and Tally Record
FORMS: DD-1907
OMB NO: 0702-0060 EXPIRATION DATE: 02/28/2006
RESPS:66,200 HOURS:8,350 COSTS(000):$0
Pre-Candidate Procedures
FORMS: USMA-375 USMA-723 USMA-450 USMA-21-12 USMA-21-27 USMA-381
OMB NO: 0702-0061 EXPIRATION DATE: 02/28/2006
RESPS:92,525 HOURS:11,720 COSTS(000):$0
Candidate Procedures
FORMS: 21-16 21-23 21-25 21-26 5-520 5-518 FL546 FL481 5-2 5-26
OMB NO: 0702-0062 EXPIRATION DATE: 02/28/2006
RESPS:16,600 HOURS:1,937 COSTS(000):$0
Offered Candidate Procedures
FORMS: 5-490 2-66 847 5-489 5-519 8-2 6-154 5-515 534 5-516
OMB NO: 0702-0073 EXPIRATION DATE: 02/28/2006
RESPS:11,000 HOURS:8,250 COSTS(000):$0
U.S. Army ROTC 4-year College Scholarship Application (for High
School Students)
FORMS: CC-114-R
OMB NO: 0702-0115 EXPIRATION DATE: 12/31/2003
RESPS:2,240 HOURS:784 COSTS(000):$0
Survey of Army Applicants who were Qualified not Enlisted (QNE)
or Those Who Entered the Delayed Entry Program (DEP) But Chose
Not to Enlist
FORMS: NONE
OMB NO: 0702-0116 EXPIRATION DATE: 12/31/2004
RESPS:519 HOURS:218 COSTS(000):$0
West Point Engineering Graduates Surveys
FORMS: NONE
OMB NO: 0702-0117 EXPIRATION DATE: 03/31/2006
RESPS:1,500 HOURS:375 COSTS(000):$0
Evaluation of Army Benefits Center - Civilian (ABC-C) Retirement
System
FORMS: NONE
OMB NO: 0702-0118 EXPIRATION DATE: 03/31/2006
RESPS:2,500 HOURS:292 COSTS(000):$0
Evaluation of Reasons for Non-Acceptance of Department of Army
Civilian Job Offers
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
12 716,151 109,454 $0
Department of the Navy
OMB NO: 0703-0011 EXPIRATION DATE: 09/30/2004
RESPS:2,500 HOURS:625 COSTS(000):$0
Academic Certification for Marine Corps Officer Candidate Program
FORMS: NAVMC-10469
OMB NO: 0703-0016 EXPIRATION DATE: 09/30/2004
RESPS:440 HOURS:220 COSTS(000):$0
Individual MCJROTC Instructor Evaluation Summary
FORMS: NAVMC-10942
OMB NO: 0703-0020 EXPIRATION DATE: 09/30/2005
RESPS:2,700 HOURS:2,025 COSTS(000):$0
Enlistee Financial Statement
FORMS: NAVCRUIT-1130/ 13
OMB NO: 0703-0028 EXPIRATION DATE: 09/30/2005
RESPS:40,000 HOURS:10,000 COSTS(000):$0
NROTC Applicant Questionaire
FORMS: NAVCRUIT-1131/6
OMB NO: 0703-0052 EXPIRATION DATE: 12/31/2003
RESPS:65,000 HOURS:13,000 COSTS(000):$0
United States Navy Illicit Behavior Screening Certificate
FORMS: NAVCRUIT-1133/ 65
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
5 110,640 25,870 $0
Departmental and Others
OMB NO: 0704-0003 EXPIRATION DATE: 09/30/2003
RESPS:28,000 HOURS:14,000 COSTS(000):$0
Application for Correction of Military Records Under the
Provisions of Title 10, U.S. Code, Section 1552
FORMS: DD-149
OMB NO: 0704-0004 EXPIRATION DATE: 11/30/2003
RESPS:8,000 HOURS:6,000 COSTS(000):$0
Application for the Review of Discharge or Dismissal from the
Armed Forces of the United States
FORMS: DD-293
OMB NO: 0704-0006 EXPIRATION DATE: 11/30/2004
RESPS:100,000 HOURS:8,300 COSTS(000):$0
Request for Verification of Birth
FORMS: DD-372
OMB NO: 0704-0007 EXPIRATION DATE: 02/29/2004
RESPS:125,000 HOURS:56,250 COSTS(000):$5
Policy Record Check
FORMS: DD-369
OMB NO: 0704-0020 EXPIRATION DATE: 07/31/2005
RESPS:1,690,048 HOURS:281,675 COSTS(000):$0
Application for Uniformed Services Identification Card -- DEERS
Enrollment
FORMS: DD-FORM-1172
OMB NO: 0704-0055 EXPIRATION DATE: 10/31/2004
RESPS:610 HOURS:610 COSTS(000):$0
Department of Defense Application for Priority Rating for
Production or Construction Equipment
FORMS: DD-691
OMB NO: 0704-0100 EXPIRATION DATE: 10/31/2004
RESPS:3,000 HOURS:1,500 COSTS(000):$2
Application for Discharge of Member of Survivor of Member of
Group Certified to Have Performed Active Duty with the Armed
Forces of the United States
FORMS: DD-2168
OMB NO: 0704-0125 EXPIRATION DATE: 09/30/2004
RESPS:2,403 HOURS:401 COSTS(000):$0
Post-election Survey of Overseas Citizens, Post-election Survey
of Local Election Officials
FORMS: NONE
OMB NO: 0704-0152 EXPIRATION DATE: 05/31/2003
RESPS:27,000 HOURS:4,500 COSTS(000):$0
DOD Educational Loan Repayment Program (LRP)
FORMS: DD-2475
OMB NO: 0704-0167 EXPIRATION DATE: 11/30/2004
RESPS:43,000 HOURS:7,167 COSTS(000):$0
Request for Reference
FORMS: DD-370
OMB NO: 0704-0173 EXPIRATION DATE: 09/30/2003
RESPS:510,000 HOURS:170,000 COSTS(000):$0
Record of Military Processing - Armed Forces of the United States
FORMS: 1966
OMB NO: 0704-0187 EXPIRATION DATE: 12/31/2005
RESPS:1,954,238 HOURS:9,870,858 COSTS(000):$0
Information Collection in Support of the DOD Acquisition Process
FORMS: NONE
OMB NO: 0704-0190 EXPIRATION DATE: 02/28/2006
RESPS:797 HOURS:614 COSTS(000):$0
Appointment of Chaplains for the Military Services
FORMS: DD-2741 DD-2088
OMB NO: 0704-0194 EXPIRATION DATE: 06/30/2004
RESPS:6,400 HOURS:9,493 COSTS(000):$0
Department of Defense Security Agreement, Appendage, and
Certificate Pertaining to Foreign Interests
FORMS: DD-441 DD-441-1 SF-328
OMB NO: 0704-0207 EXPIRATION DATE: 10/31/2004
RESPS:6,000 HOURS:2,000 COSTS(000):$0
Militarily Critical Technical Data Agreement
FORMS: DD-2345
OMB NO: 0704-0214 EXPIRATION DATE: 09/30/2005
RESPS:53,160 HOURS:765,498 COSTS(000):$0
Defense Federal Acquisition Reguilation Supplement (DFARS) Part
217, Special Contracting Methods, and related provisions and
clauses in DFARS 252.217
FORMS: NONE
OMB NO: 0704-0216 EXPIRATION DATE: 08/31/2003
RESPS:49 HOURS:859 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS) Part
228, Bonds and Insurance, and related clauses at 252.228
FORMS: NONE
OMB NO: 0704-0225 EXPIRATION DATE: 08/31/2004
RESPS:22,602 HOURS:13,758 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement Part 204,
Administrative Matters, and related clauses at 252.204
FORMS: DD-2051 DD-2051-1
OMB NO: 0704-0229 EXPIRATION DATE: 03/31/2004
RESPS:223,942 HOURS:374,268 COSTS(000):$0
Defense Federal Acquisition Supplement Part 225, Foreign
Acquisition, and related clauses at Part 252.225.
FORMS: DD-2139
OMB NO: 0704-0231 EXPIRATION DATE: 06/30/2004
RESPS:800 HOURS:400 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS)
Subpart 237.70, Mortuary Services, DFARS clause 252.237-7011,
Preparation History, and DD Form 2063, Record of Preparation...
FORMS: DD-2063
OMB NO: 0704-0232 EXPIRATION DATE: 08/31/2004
RESPS:141 HOURS:5,350 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS)
Subpart 215.8, Price Negotiation, and related clauses at 252.215.
FORMS: NONE
OMB NO: 0704-0245 EXPIRATION DATE: 07/31/2004
RESPS:464,682 HOURS:149,874 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS) Part
247, Transportation, and related clauses at 252.247
FORMS: NONE
OMB NO: 0704-0246 EXPIRATION DATE: 02/28/2006
RESPS:42,497 HOURS:50,170 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS) Part
245, Government Property, related clauses in DFARS 252, and
related forms in DFARS 253
FORMS: DD-FORM-1149 1149C 1342 1419 1637 1639 1640 1662
OMB NO: 0704-0248 EXPIRATION DATE: 10/31/2004
RESPS:7,800,000 HOURS:988,000 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement, Appendix F,
Material Inspection and Receiving Report
FORMS: DD-250 DD-250C DD-250-1
OMB NO: 0704-0250 EXPIRATION DATE: 02/28/2006
RESPS:86,215 HOURS:217,645 COSTS(000):$0
Defense Federal Acquisition Regulation Supplment (DFARS) Part
242, Contract Administration, related clauses in DFARS 252, and
related forms in DFARS 253
FORMS: DD-FORM-1659
OMB NO: 0704-0252 EXPIRATION DATE: 10/31/2004
RESPS:10,500 HOURS:5,250 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement, Use of
Government Sources by Contractors, and related clauses in Part
252
FORMS: NONE
OMB NO: 0704-0253 EXPIRATION DATE: 07/31/2004
RESPS:90 HOURS:1,440 COSTS(000):$0
Subcontracting Policies and Procedures - DOD FAR Supplement Part
244
FORMS: NONE
OMB NO: 0704-0255 EXPIRATION DATE: 10/31/2004
RESPS:2,740 HOURS:276,625 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement Part 236,
Construction and Architect-Engineer Contracts, and Related
Clauses at 252.236
FORMS: NONE
OMB NO: 0704-0259 EXPIRATION DATE: 06/30/2005
RESPS:136 HOURS:552 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS) Part
216, Types of Contracts, and related clauses at 252.216
FORMS: NONE
OMB NO: 0704-0261 EXPIRATION DATE: 08/31/2005
RESPS:21,563 HOURS:5,391 COSTS(000):$0
Department of Defense Standard Tender of Freight Services
FORMS: MT-364-R
OMB NO: 0704-0264 EXPIRATION DATE: 06/30/2004
RESPS:2,000 HOURS:833 COSTS(000):$0
Registration for Scientific and Technical Information Services
FORMS: DD-1540
OMB NO: 0704-0267 EXPIRATION DATE: 04/30/2004
RESPS:42,058 HOURS:420,580 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS) Part
230, Cost Accounting Standards Administration, and DD Form 1861,
Contract Facilities Capital Cost of Money
FORMS: DD-1861
OMB NO: 0704-0272 EXPIRATION DATE: 08/31/2004
RESPS:14,726 HOURS:9,997 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS)
Subpart 223, Environment, Conservation, and Occupational Safety;
and Related Clauses at DFARS Part 252
FORMS: NONE
OMB NO: 0704-0286 EXPIRATION DATE: 08/31/2004
RESPS:6,153 HOURS:6,153 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement Part 205,
Publicizing Contract Actions, and DFARS 252.205-7000, Provision
of Information to Cooperative Acreement Holders
FORMS: NONE
OMB NO: 0704-0290 EXPIRATION DATE: 06/30/2003
RESPS:43,000 HOURS:5,547 COSTS(000):$0
Armed Forces Participation in Public Events
FORMS: DD-2535 DD-2536
OMB NO: 0704-0305 EXPIRATION DATE: 09/30/2003
RESPS:3,940 HOURS:4,815 COSTS(000):$0
Telecommunications Service Priority System
FORMS: SF-314 SF-315 SF-317 SF-318 SF-319
OMB NO: 0704-0320 EXPIRATION DATE: 07/31/2005
RESPS:178 HOURS:1,246 COSTS(000):$0
Procurement Technical Assistance Center Cooperative Agreement
Performance Report
FORMS: DLA-1806
OMB NO: 0704-0321 EXPIRATION DATE: 05/31/2003
RESPS:5,160 HOURS:7,740 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS) Part
232, contract Financing, and the clause at DFARS 252.232-7002
Progress Payments for Foreign Military Sales Acquisition
FORMS: NONE
OMB NO: 0704-0323 EXPIRATION DATE: 07/31/2003
RESPS:293,401 HOURS:12,030 COSTS(000):$0
Third Party Collection Program (Record of Other Health Insurance)
FORMS: DD-2569
OMB NO: 0704-0324 EXPIRATION DATE: 05/31/2004
RESPS:1,165 HOURS:276 COSTS(000):$0
Department of Defense Public and Community Service (PACS) Program
FORMS: 2581 2581-1
OMB NO: 0704-0328 EXPIRATION DATE: 05/31/2005
RESPS:102,000 HOURS:10,200 COSTS(000):$0
DOD Building Pass Application
FORMS: DD-2249
OMB NO: 0704-0332 EXPIRATION DATE: 03/31/2004
RESPS:393 HOURS:931 COSTS(000):$0
Defense Federal Acquistion Regualtion Supplement (DFARS)
Appendix I - - DOD Pilot Mentor Protege Program
FORMS: NONE
OMB NO: 0704-0334 EXPIRATION DATE: 09/30/2004
RESPS:5,000 HOURS:1,667 COSTS(000):$0
Automated Repatriation Reporting System
FORMS: DD-FORM_2585
OMB NO: 0704-0336 EXPIRATION DATE: 10/31/2004
RESPS:15,152 HOURS:821,052 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS)
223.570, Drug-Free Work Force, and DFARS clause 252.223-7004,
Drug-Free Work Force
FORMS: NONE
OMB NO: 0704-0341 EXPIRATION DATE: 10/31/2004
RESPS:1,598 HOURS:1,806 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS) Part
239, Acquisition of Information Technology, and associated
clauses at DFARS 252.239-7000 and 252.239-7006
FORMS: NONE
OMB NO: 0704-0347 EXPIRATION DATE: 06/30/2003
RESPS:81 HOURS:7 COSTS(000):$0
Request for Approval for Qualification Training and Approval of
Contractor Flight Crewmember
FORMS: DD-2627 DD-2628
OMB NO: 0704-0357 EXPIRATION DATE: 12/31/2005
RESPS:756 HOURS:126 COSTS(000):$0
Validation of Public or Community Service Employment Performed
by Retired Personnel Retired Under the Temporary Early
Retirement Authority (TERA) for Increased Retirement Compensation
FORMS: 2676
OMB NO: 0704-0359 EXPIRATION DATE: 08/31/2004
RESPS:800 HOURS:800 COSTS(000):$0
Defense Federal Acqusition Regulation Supplement (DFARS) Part
232 Contract Financing, and related clause at DFARS
252.232-7007, Limitation of Government's Obligation
FORMS: NONE
OMB NO: 0704-0364 EXPIRATION DATE: 06/30/2005
RESPS:808 HOURS:202 COSTS(000):$0
Continued Health Care Benefit Program (CHCBP) Application
FORMS: DD-2837
OMB NO: 0704-0366 EXPIRATION DATE: 03/31/2004
RESPS:185 HOURS:1,619 COSTS(000):$0
National Security Education Program (NSEP Grants to Institutions
of Higher Education)
FORMS: DD-2729 DD-2730
OMB NO: 0704-0367 EXPIRATION DATE: 05/31/2004
RESPS:9,314 HOURS:4,657 COSTS(000):$17
Indebtedness of Military Personnel -Involuntary Allotments
FORMS: DD-2653
OMB NO: 0704-0368 EXPIRATION DATE: 03/31/2004
RESPS:600 HOURS:100 COSTS(000):$0
National Security Education Program (Service Agreement Report
for Scholarshi8p and Fellowship Awards)
FORMS: DD-2752 DD-2753
OMB NO: 0704-0369 EXPIRATION DATE: 11/30/2003
RESPS:1,185,005 HOURS:4,320,447 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement Subparts
227.72, Rights in Computer Software and Computer Software
Documentation; and related clauses and provisions at 252.227
FORMS: NONE
OMB NO: 0704-0370 EXPIRATION DATE: 03/31/2005
RESPS:25,120 HOURS:4,127 COSTS(000):$15
Department of Defense Dependents Schools (DoDDS) Overseas
Employment Opportunities for Education
FORMS: DS-5010 DS-5011 DS-5013 DS-5012
OMB NO: 0704-0380 EXPIRATION DATE: 08/31/2004
RESPS:7,500 HOURS:500 COSTS(000):$0
Commissary Customer Service Survey
FORMS: DECA-60-28
OMB NO: 0704-0382 EXPIRATION DATE: 12/31/2004
RESPS:40,000 HOURS:13,200 COSTS(000):$0
End-Use Certificate
FORMS: DLA-1822
OMB NO: 0704-0384 EXPIRATION DATE: 03/31/2006
RESPS:32,164 HOURS:8,041 COSTS(000):$0
DOD Request for Personnel Security Investigations
FORMS: DD-1879
OMB NO: 0704-0386 EXPIRATION DATE: 10/31/2004
RESPS:1 HOURS:41 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS) Part
219, Small Business Programs and Associated Clauses in Part
252.219
FORMS: NONE
OMB NO: 0704-0390 EXPIRATION DATE: 03/31/2005
RESPS:22 HOURS:88 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS) Part
229, Taxes, and related clauses at 252.229
FORMS: NONE
OMB NO: 0704-0391 EXPIRATION DATE: 08/31/2003
RESPS:20 HOURS:20 COSTS(000):$0
Defense Export Loan Guarantee (DELG) Application
FORMS: DD-2747
OMB NO: 0704-0394 EXPIRATION DATE: 06/30/2003
RESPS:800 HOURS:200 COSTS(000):$0
Defense Reutilization and Marketing Service Customer Comment Card
FORMS: NONE
OMB NO: 0704-0395 EXPIRATION DATE: 07/31/2003
RESPS:10,000 HOURS:833 COSTS(000):$0
Pentagon Reservation Parking Permit Application
FORMS: DD-1199
OMB NO: 0704-0396 EXPIRATION DATE: 08/31/2003
RESPS:19,000 HOURS:19,000 COSTS(000):$0
Department of Defense Medical Examiniation Review Board Medical
Information Collection Forms
FORMS: DD-2351/-2369 DD-2370/-2372 DD-2374/-2375 DD-2378/-2379
DD-2380/-2381 DD-2382/-2383 DD-2480/-2489 DD-2492/-2632
OMB NO: 0704-0397 EXPIRATION DATE: 02/28/2006
RESPS:440 HOURS:2,120 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS) Part
243, Contract Modification and related clause at DFARS
252.243-7002
FORMS: NONE
OMB NO: 0704-0398 EXPIRATION DATE: 08/31/2004
RESPS:771 HOURS:771 COSTS(000):$0
Substitutions for Military or Federal Specifications and
Standards, Defense Federal Acquisition Regulation Supplement
(DFARS) Section 211.273, and related clause in DFARS 272.211-7005
FORMS: NONE
OMB NO: 0704-0400 EXPIRATION DATE: 12/31/2003
RESPS:300,000 HOURS:150,000 COSTS(000):$0
Central Contractor Registration (CCR)
FORMS: NONE
OMB NO: 0704-0402 EXPIRATION DATE: 11/30/2004
RESPS:200 HOURS:200 COSTS(000):$2
Application for Annuity - Certain Military Surviving Spouses
FORMS: DD-2769
OMB NO: 0704-0403 EXPIRATION DATE: 08/31/2004
RESPS:2,492 HOURS:415 COSTS(000):$0
Customer Satisfaction Survey - Generic Clearance
FORMS: NONE
OMB NO: 0704-0407 EXPIRATION DATE: 05/31/2005
RESPS:50,000 HOURS:5,000 COSTS(000):$0
Commissary Evaluation and Utility Surveys - Generic
FORMS: NONE
OMB NO: 0704-0411 EXPIRATION DATE: 05/31/2003
RESPS:16,470 HOURS:7,400 COSTS(000):$2
Exceptional Family Member Program
FORMS: DD-2792
OMB NO: 0704-0412 EXPIRATION DATE: 07/31/2003
RESPS:145 HOURS:435 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS)
Appendix I, DOD Pilot Mentor Protege Program Improvements
FORMS: NONE
OMB NO: 0704-0413 EXPIRATION DATE: 08/31/2003
RESPS:850,000 HOURS:135,833 COSTS(000):$0
Medical Screening of Military Personnel
FORMS: DD-2807-1 DD-2807-2
OMB NO: 0704-0415 EXPIRATION DATE: 03/31/2004
RESPS:300,000 HOURS:100,000 COSTS(000):$0
Application for Department of Defense Common Access Card - Deers
Enrollment
FORMS: DD-1172-2
OMB NO: 0704-0416 EXPIRATION DATE: 12/31/2003
RESPS:1,000 HOURS:2,500 COSTS(000):$0
Defense Systems Management College (DSMC) Information Technology
Study
FORMS: NONE
OMB NO: 0704-0417 EXPIRATION DATE: 09/30/2004
RESPS:11,000 HOURS:13,750 COSTS(000):$0
Personnel Security Investigation Projection for Industry Survey
FORMS: DSS-232
OMB NO: 0704-0418 EXPIRATION DATE: 02/29/2004
RESPS:225.800 HOURS:45,160 COSTS(000):$0
Personnel Security Clearance Change Notification
FORMS: DISCOFORM562
OMB NO: 0704-0420 EXPIRATION DATE: 04/30/2004
RESPS:2,880 HOURS:144 COSTS(000):$0
Interactive Customer Evaluation System (ICE)
FORMS: NONE
OMB NO: 0704-0421 EXPIRATION DATE: 03/31/2005
RESPS:7,275 HOURS:2,001 COSTS(000):$0
Department of Defense Education Activity Customer Satisfaction
Survey for Parents and Students
FORMS: NONE
OMB NO: 0704-0422 EXPIRATION DATE: 04/30/2005
RESPS:1,335 HOURS:334 COSTS(000):$0
2001 Biennial Review of Defense Agencies and DOD Field Activities
FORMS: NONE
OMB NO: 0704-0424 EXPIRATION DATE: 04/30/2005
RESPS:6,000 HOURS:2,500 COSTS(000):$0
Defense Security Service Customer Satisfaction Survey
FORMS: NONE
OMB NO: 0704-0425 EXPIRATION DATE: 08/31/2003
RESPS:50 HOURS:400 COSTS(000):$0
Application for Department of Defense Impact Aid for Children
with Severe Disabilities
FORMS: SD-816 SD-816C
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
81 16,651,996 19,436,292 $43
U.S. Army Corps of Engineers
OMB NO: 0710-0001 EXPIRATION DATE: 11/30/2005
RESPS:214,150 HOURS:17,750 COSTS(000):$0
Corps of Engineers Civil Works Questionnairs - Generic Clearance
FORMS: NONE
OMB NO: 0710-0003 EXPIRATION DATE: 12/31/2004
RESPS:85,500 HOURS:340,000 COSTS(000):$0
Application for a Department of the Army Permit
FORMS: 4345
OMB NO: 0710-0005 EXPIRATION DATE: 09/30/2003
RESPS:5,400 HOURS:2,500 COSTS(000):$0
Record of Arrivals and Departures of Vessels at Marine Terminals.
FORMS: 3926
OMB NO: 0710-0006 EXPIRATION DATE: 09/30/2003
RESPS:228,752 HOURS:44,479 COSTS(000):$0
Vessel Operation Report
FORMS: 3925 3925B 3925P 3925C
OMB NO: 0710-0007 EXPIRATION DATE: 08/31/2005
RESPS:1,489 HOURS:372 COSTS(000):$0
Terminal and Transfer Facilities Description
FORMS: IWR-1 IWR-2 IWR-3 IWR-4 IWR-5 IWR-6 IWR-7 IWR-8 IWR-9
OMB NO: 0710-0008 EXPIRATION DATE: 08/31/2005
RESPS:695,304 HOURS:28,507 COSTS(000):$0
Lock Performance Monitoring System (LPMS) Waterway Traffic Report
FORMS: 3102C 3102D
OMB NO: 0710-0009 EXPIRATION DATE: 10/31/2004
RESPS:2,500 HOURS:2,000 COSTS(000):$0
Description of Vessels, Description of Operations
FORMS: 3931 3932
OMB NO: 0710-0012 EXPIRATION DATE: 08/31/2005
RESPS:60,000 HOURS:15,000 COSTS(000):$0
Customer Service Survey - Regulatory Program US Army Corps of
Engineers
FORMS: ENG-5065
OMB NO: 0710-0013 EXPIRATION DATE: 02/29/2004
RESPS:164,367 HOURS:29,737 COSTS(000):$0
Shipper's Export Declaration (SED) Program
FORMS: 7513
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
9 1,457,462 480,345 $0
Office of Assistant Secretary for Health Affairs
OMB NO: 0720-0001 EXPIRATION DATE: 08/31/2003
RESPS:14,500,000 HOURS:3,625,000 COSTS(000):$0
Health Insurance Claim Form
FORMS: HCFA-1500
OMB NO: 0720-0005 EXPIRATION DATE: 08/31/2003
RESPS:60 HOURS:30 COSTS(000):$0
Professional Qualifications, Medical and Peer Reviewers
FORMS: CHAMPUS-780
OMB NO: 0720-0006 EXPIRATION DATE: 03/31/2006
RESPS:1,035,000 HOURS:258,750 COSTS(000):$0
CHAMPUS Claims Patient's Request for Medical Payment
FORMS: DD-2642
OMB NO: 0720-0013 EXPIRATION DATE: 03/31/2005
RESPS:2,100,000 HOURS:525,000 COSTS(000):$859
Health Insurance Claim Form, HCFA 1450
FORMS: HCF-1450-UB92
OMB NO: 0720-0015 EXPIRATION DATE: 12/31/2003
RESPS:50,000 HOURS:12,500 COSTS(000):$0
TRICARE Retiree Dental Program Enrollment Application
FORMS: NONE
OMB NO: 0720-0022 EXPIRATION DATE: 02/28/2006
RESPS:885,000 HOURS:44,250 COSTS(000):$0
DoD Active Duty/Reserve Forces Dental Examination
FORMS: DD-2813
OMB NO: 0720-0023 EXPIRATION DATE: 07/31/2003
RESPS:2,000 HOURS:333 COSTS(000):$0
Pharmacy Redesign Pilot Program
FORMS: DD-2814
OMB NO: 0720-0024 EXPIRATION DATE: 06/30/2003
RESPS:900 HOURS:300 COSTS(000):$0
Survey of Prescribers in Military Treatment Facilities and
TRICARE Contracts
FORMS: NONE
OMB NO: 0720-0027 EXPIRATION DATE: 10/31/2004
RESPS:2,106,071 HOURS:703,248 COSTS(000):$0
Health Evaluation Assessment Review (HEAR 2.X)
FORMS: NONE
OMB NO: 0720-0028 EXPIRATION DATE: 03/31/2005
RESPS:20,689 HOURS:2,150 COSTS(000):$0
TRICARE Plus Enrollment and Disenrollment Applications
FORMS: DD-X437 DD-X438
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
10 20,699,720 5,171,561 $859
Defense Finance and Accounting Service
OMB NO: 0730-0001 EXPIRATION DATE: 09/30/2005
RESPS:3,600 HOURS:720 COSTS(000):$0
Child Annuitant's School Certification
FORMS: DD-2788
OMB NO: 0730-0002 EXPIRATION DATE: 04/30/2004
RESPS:108,500 HOURS:9,042 COSTS(000):$0
Statement of Claimant Requesting Recertified Check
FORMS: DD-2660
OMB NO: 0730-0003 EXPIRATION DATE: 06/30/2004
RESPS:15,000 HOURS:2,000 COSTS(000):$0
Customer Satisfaction Surveys - Generic
FORMS: NONE
OMB NO: 0730-0005 EXPIRATION DATE: 12/31/2003
RESPS:386,000 HOURS:193,000 COSTS(000):$0
Personal Check Cashing Agreement
FORMS: DD-2761
OMB NO: 0730-0008 EXPIRATION DATE: 11/30/2004
RESPS:20,520 HOURS:5,064 COSTS(000):$0
Application for Former Spouse Payments from Retired Pay
FORMS: DD-2293
OMB NO: 0730-0009 EXPIRATION DATE: 09/30/2005
RESPS:6,000 HOURS:12,000 COSTS(000):$0
Waiver/Remission of Indebtedness Application
FORMS: DD-2789
OMB NO: 0730-0010 EXPIRATION DATE: 09/30/2005
RESPS:300 HOURS:120 COSTS(000):$0
Custodianship Certificate to Support Claim on Behalf of Minor
Children of Deceased Members of the Armed Forces
FORMS: DD-2790
OMB NO: 0730-0011 EXPIRATION DATE: 08/31/2003
RESPS:120 HOURS:24 COSTS(000):$0
Physician Certificate for Child Annuitant
FORMS: DD-X405
OMB NO: 0730-0012 EXPIRATION DATE: 09/30/2003
RESPS:300 HOURS:150 COSTS(000):$0
Trustee Report
FORMS: DD-2826
OMB NO: 0730-0013 EXPIRATION DATE: 09/30/2003
RESPS:50 HOURS:13 COSTS(000):$0
Application for Trusteeship
FORMS: DD-2827
OMB NO: 0730-0014 EXPIRATION DATE: 05/31/2004
RESPS:19,440 HOURS:24,300 COSTS(000):$0
Dependency Statements: Parent, Child Born Out of Wedlock,
Incapacitated Child Over Age 21, Full ?Time Student 21-22 Years
of Age, and Ward of a Court
FORMS: DD-137-3 DD-137-4 DD-137-5 DD-137-6 DD-137-7
OMB NO: 0730-0015 EXPIRATION DATE: 04/30/2004
RESPS:10,000 HOURS:833 COSTS(000):$0
Request for Information Regarding Deceased Debtor
FORMS: DD-2840
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
12 569,830 247,266 $0
Office of the Secretary
OMB NO: 0790-0003 EXPIRATION DATE: 09/30/2004
RESPS:150 HOURS:150 COSTS(000):$0
Base Realignment and Closure (BRAC) Military Base Reuse Status
FORMS: DD-2740
OMB NO: 0790-0004 EXPIRATION DATE: 02/29/2004
RESPS:71 HOURS:2,840 COSTS(000):$0
Revitalizing Base Closure Communities, Economic Development
Conveyance Annual Financial Statement
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
2 221 2,990 $0
AGENCY TOTALS:
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
156 41,740,892 26,988,192 $902
Department of Education
Department of Education
OMB NO: 1800-0011 EXPIRATION DATE: 11/30/2003
RESPS:10,000 HOURS:25,120 COSTS(000):$0
Master Plan for Customer Satisfaction Surveys and Focus Groups
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
1 10,000 25,120 $0
Office of Elementary and Secondary Education
OMB NO: 1810-0036 EXPIRATION DATE: 02/28/2005
RESPS:1,061,320 HOURS:531,211 COSTS(000):$0
Applications for Assistance (sections 8002 and 8003) Impact Aid
Program
FORMS: ED-4019
OMB NO: 1810-0054 EXPIRATION DATE: 01/31/2004
RESPS:90 HOURS:2,180 COSTS(000):$0
Application for the High School Equivalency Program (HEP) and
College Assistance Migrant Program (CAMP) (1890-0001)(KA)
FORMS: NONE
OMB NO: 1810-0060 EXPIRATION DATE: 04/30/2005
RESPS:3,052 HOURS:4,224 COSTS(000):$0
Annual Report of Children in State Agency and Locally Operated
Institutions for Neglected and Delinquent Children
FORMS: ED-4376
OMB NO: 1810-0540 EXPIRATION DATE: 05/31/2003
RESPS:30 HOURS:450 COSTS(000):$0
Application for the Even Start Family Literacy Program - Indian
Tribes and Tribal Organizations
FORMS: CFDA#84.258
OMB NO: 1810-0541 EXPIRATION DATE: 04/30/2003
RESPS:60 HOURS:2,700 COSTS(000):$0
Migrant Education Even Start Family Literacy
FORMS: NONE
OMB NO: 1810-0576 EXPIRATION DATE: 10/31/2005
RESPS:52 HOURS:18,160 COSTS(000):$0
Consolidated State Application
FORMS: NONE
OMB NO: 1810-0581 EXPIRATION DATE: 05/31/2003
RESPS:33,759 HOURS:2,586,428 COSTS(000):$0
State educational agency local educational agency, and school
data collection and reporting under ESEA, Title I, Part A
FORMS: NONE
OMB NO: 1810-0614 EXPIRATION DATE: 06/30/2003
RESPS:14,452 HOURS:134,768 COSTS(000):$0
consolidated State Performance Report and State Self-Review
FORMS: NONE
OMB NO: 1810-0620 EXPIRATION DATE: 09/30/2005
RESPS:25 HOURS:200 COSTS(000):$0
State Agency Use of Alternative Method to Distribute Title I
Funds to LEAs with Fewer Than 20,000 Total Residents
FORMS: NONE
OMB NO: 1810-0622 EXPIRATION DATE: 09/30/2005
RESPS:52 HOURS:2,080 COSTS(000):$0
SEA Procedures for Adjusting ED-Determined Title I Allocations
to Local Education Agencies (LEAs)
FORMS: NONE
OMB NO: 1810-0625 EXPIRATION DATE: 04/30/2003
RESPS:45 HOURS:1,800 COSTS(000):$0
Ed-Flex State Application Guidance
FORMS: NONE
OMB NO: 1810-0634 EXPIRATION DATE: 04/30/2003
RESPS:23 HOURS:552 COSTS(000):$0
Reading Excellence Act Performance Report (KA)
FORMS: CFDA#84.338
OMB NO: 1810-0646 EXPIRATION DATE: 10/31/2005
RESPS:4,552 HOURS:4,830 COSTS(000):$0
Application Package for the REAP Small, Rural School Achievement
Program (KA)
FORMS: 84.358A
OMB NO: 1810-0648 EXPIRATION DATE: 07/31/2005
RESPS:57 HOURS:3,306 COSTS(000):$0
Application for State Grants for Reading First (KA)
FORMS: CFDA#84.357
OMB NO: 1810-0649 EXPIRATION DATE: 04/30/2003
RESPS:100 HOURS:500 COSTS(000):$0
FY 2002 Migrant Education Program (MEP) Consortium Incentive
Grants (1890-0001) (KA)
FORMS: CFDA384.144
OMB NO: 1810-0652 EXPIRATION DATE: 05/31/2005
RESPS:1,500 HOURS:45,000 COSTS(000):$0
Application for Improving Literacy Through School Libraries
Grant Program
FORMS: 84.364
OMB NO: 1810-0653 EXPIRATION DATE: 06/30/2005
RESPS:56 HOURS:112 COSTS(000):$0
State Progress Report - School Renovation, IDEA, and Technology
Grants Program (KA)
FORMS: 84.352A
OMB NO: 1810-0654 EXPIRATION DATE: 10/31/2004
RESPS:932 HOURS:14,332 COSTS(000):$0
Early Reading First Program Federal Register Notice Inviting
Applications, and Application Packet (KA)
FORMS: 84.359
OMB NO: 1810-0655 EXPIRATION DATE: 01/31/2006
RESPS:240 HOURS:19,200 COSTS(000):$0
Local-Flex Application (KA)
FORMS: NONE
OMB NO: 1810-0656 EXPIRATION DATE: 12/31/2005
RESPS:100 HOURS:200 COSTS(000):$0
FY 2002 Native Hawaiian Education Council
FORMS: 84.362B
OMB NO: 1810-0657 EXPIRATION DATE: 08/31/2003
RESPS:438 HOURS:1,454 COSTS(000):$0
Impact Aid Discretionary Construction Grant Program
FORMS: 84.041
OMB NO: 1810-0660 EXPIRATION DATE: 02/28/2006
RESPS:21 HOURS:13,440 COSTS(000):$0
State-Flex Application (KA)
FORMS: NONE
OMB NO: 1810-0662 EXPIRATION DATE: 05/31/2003
RESPS:43 HOURS:19,925 COSTS(000):$0
Migrant Education Program (MEP) Final Regulations Sections
200.83 200.84 and 200.88
FORMS: CFDA-84.011
OMB NO: 1810-0663 EXPIRATION DATE: 01/31/2006
RESPS:51 HOURS:612 COSTS(000):$0
Information on Students Served by McKinney-Vento Homeless
Assistance Act Subgrants
FORMS: CDF#84.196
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
24 1,121,050 3,407,664 $0
Office of Special Education and Rehabilitative Services
OMB NO: 1820-0009 EXPIRATION DATE: 07/31/2005
RESPS:52 HOURS:702 COSTS(000):$0
Report of Randolph-Sheppard Vending Facility Program (SC)
FORMS: RSA-15
OMB NO: 1820-0013 EXPIRATION DATE: 02/28/2006
RESPS:320 HOURS:320 COSTS(000):$0
Quarterly Cumulative Caseload Report (SC)
FORMS: RSA-113
OMB NO: 1820-0017 EXPIRATION DATE: 02/28/2006
RESPS:82 HOURS:385 COSTS(000):$0
Annual Program Cost Report (SC)
FORMS: RSA-2
OMB NO: 1820-0018 EXPIRATION DATE: 08/31/2004
RESPS:1,000 HOURS:40,000 COSTS(000):$0
Application Kit for New Grants Under the Rehabilitation Services
Administration
FORMS: NONE
OMB NO: 1820-0027 EXPIRATION DATE: 11/30/2003
RESPS:1,000 HOURS:20,000 COSTS(000):$0
Applications for Grants under Disability and Rehabilitation
Research (1890-0001)(SC)
FORMS: NONE
OMB NO: 1820-0028 EXPIRATION DATE: 05/31/2003
RESPS:1,200 HOURS:30,000 COSTS(000):$0
Discretionary Grant Application -- Individuals with Disabilities
Education Act
FORMS: NONE
OMB NO: 1820-0030 EXPIRATION DATE: 01/31/2006
RESPS:57 HOURS:570 COSTS(000):$0
State Eligibility Plan Under Part B of the Individuals with
Disabilities Education Act (SC)
FORMS: ED-9055
OMB NO: 1820-0043 EXPIRATION DATE: 07/31/2004
RESPS:58 HOURS:30,682 COSTS(000):$0
Report of Children with Disabilities Receiving Special Education
under Part B of the Individuals with Disabilites Education Act
(SC)
FORMS: 869-5
OMB NO: 1820-0500 EXPIRATION DATE: 01/31/2004
RESPS:82 HOURS:1,002,050 COSTS(000):$0
State Vocational Rehabilitation Services Program Final Rules
FORMS: ED(RSA)-SPVR
OMB NO: 1820-0508 EXPIRATION DATE: 05/31/2003
RESPS:80 HOURS:4,240 COSTS(000):$0
Final Regulations to Amend CFR, Title 34, Chapter III, Part 361,
by adding a new subpart E, entitled "Evaluation Standards and
Performance Indicators"
FORMS: RSA-911
OMB NO: 1820-0509 EXPIRATION DATE: 02/28/2005
RESPS:75,560 HOURS:15,292 COSTS(000):$0
Lists of Hearing Officers and Mediators
FORMS: NONE
OMB NO: 1820-0514 EXPIRATION DATE: 12/31/2003
RESPS:1,170,000 HOURS:40,667 COSTS(000):$105,000
Application for Free Loan Service of Captioned Media Program
(English and Spanish Version) and Media Response Card (English
and Spanish Version)
FORMS: NONE
OMB NO: 1820-0517 EXPIRATION DATE: 07/31/2004
RESPS:58 HOURS:272,890 COSTS(000):$0
Part B, Individuals with Disabilities Education Act
Implementation of FAPE Requirements (SC)
FORMS: NONE
OMB NO: 1820-0518 EXPIRATION DATE: 07/31/2004
RESPS:58 HOURS:7,685 COSTS(000):$0
Personnel Employed to Provide Special Education and Related
Services for Children with Disabilities (SC)
FORMS: NONE
OMB NO: 1820-0520 EXPIRATION DATE: 08/31/2003
RESPS:1 HOURS:9 COSTS(000):$0
Written Application for the Client Assistance Program
FORMS: NONE
OMB NO: 1820-0521 EXPIRATION DATE: 07/31/2004
RESPS:58 HOURS:53,244 COSTS(000):$0
Report of Children with Disabilities Exiting Special Education
During the School Year (SC)
FORMS: 869-3
OMB NO: 1820-0527 EXPIRATION DATE: 04/30/2004
RESPS:55 HOURS:3,300 COSTS(000):$0
State Plan for Independent Living and Center for Independent
Living Programs (SC)
FORMS: NONE
OMB NO: 1820-0528 EXPIRATION DATE: 02/29/2004
RESPS:56 HOURS:350 COSTS(000):$7
Annual Client Assistance Program (CAP) Report
FORMS: RSA-227
OMB NO: 1820-0530 EXPIRATION DATE: 02/29/2004
RESPS:450 HOURS:1,800 COSTS(000):$0
Performance Report - Training Personnel for the Education of
Individuals with Disabilities Education Act (IDEA) (SC)
FORMS: NONE
OMB NO: 1820-0550 EXPIRATION DATE: 04/30/2005
RESPS:56 HOURS:168 COSTS(000):$0
Infants and Toddlers with Disabilities Program (Part C) of the
Individuals with Disabilities Education Act (IDEA)
FORMS: 1-B20-26P
OMB NO: 1820-0556 EXPIRATION DATE: 07/31/2004
RESPS:57 HOURS:5,187 COSTS(000):$0
Report of Early Intervention Services on IFSPs Provided to
Infants, Toddlers and Their Families in Accordance with Part C
and Report of Number and Type of Personnel Employed and........
FORMS: NONE
OMB NO: 1820-0557 EXPIRATION DATE: 07/31/2004
RESPS:57 HOURS:5,472 COSTS(000):$0
Report of Infants and Toddlers Receiving Early Intervention
Services and of Program Settings Where Services are Provided in
Accordance with Part C, and Report on Infants and Toddlers.....
FORMS: NONE
OMB NO: 1820-0563 EXPIRATION DATE: 11/30/2005
RESPS:80 HOURS:160 COSTS(000):$3
Annual Report on Appeals Process (SC)
FORMS: RSA-722
OMB NO: 1820-0572 EXPIRATION DATE: 02/28/2005
RESPS:56 HOURS:2,240 COSTS(000):$0
Annual Progress Reporting form for Assistive Technology Grantees
(SC)
FORMS: NONE
OMB NO: 1820-0578 EXPIRATION DATE: 08/31/2003
RESPS:57 HOURS:1,710 COSTS(000):$0
Annual Performance Report and Report to the Secretary Under the
Infants and Toddlers with Disabilities Proram (Part C, IDEA)
FORMS: NONE
OMB NO: 1820-0599 EXPIRATION DATE: 02/28/2005
RESPS:1,079 HOURS:10,790 COSTS(000):$0
Part B Complaint Procedures (SC)
FORMS: NONE
OMB NO: 1820-0600 EXPIRATION DATE: 02/28/2005
RESPS:28,844 HOURS:28,844 COSTS(000):$0
Local Educational Agency Application Under Part B of the
FORMS: NONE
OMB NO: 1820-0606 EXPIRATION DATE: 11/30/2003
RESPS:336 HOURS:11,760 COSTS(000):$0
Section 704 Annual Performance Report (Parts I and II)
FORMS: ED(RSA)-704-I ED(RSA)-704-II
OMB NO: 1820-0608 EXPIRATION DATE: 03/31/2004
RESPS:55 HOURS:440 COSTS(000):$0
Independent Living Services For Older Individuals Who Are Blind
FORMS: ED(RSA)-7-OB
OMB NO: 1820-0616 EXPIRATION DATE: 12/31/2003
RESPS:6,689 HOURS:5,072 COSTS(000):$0
National Early Intervention Longitudinal Study
FORMS: NONE
OMB NO: 1820-0617 EXPIRATION DATE: 02/29/2004
RESPS:1 HOURS:165 COSTS(000):$0
Grantee Reporting form (SC)
FORMS: NONE
OMB NO: 1820-0620 EXPIRATION DATE: 09/30/2005
RESPS:30 HOURS:2,700 COSTS(000):$0
Application for New Grants -- State Program Improvement Grants
for Children with Disabilities
FORMS: NONE
OMB NO: 1820-0621 EXPIRATION DATE: 07/31/2004
RESPS:58 HOURS:149,350 COSTS(000):$0
Report of Children with Disabilities Unilaterally Removed or
Suspended/Expelled for More Than 10 Days (SC)
FORMS: NONE
OMB NO: 1820-0622 EXPIRATION DATE: 05/31/2005
RESPS:8,000 HOURS:152,500 COSTS(000):$0
Special Education - Personnel Preparation to Improve Services
and Results for Children with Disabilities
FORMS: NONE
OMB NO: 1820-0625 EXPIRATION DATE: 08/31/2005
RESPS:57 HOURS:9 COSTS(000):$0
Protection and Advocacy of Individual Rights (PAIR) Program
Assurances (SC)
FORMS: NONE
OMB NO: 1820-0627 EXPIRATION DATE: 03/31/2006
RESPS:57 HOURS:342 COSTS(000):$0
Annual Protection and Advocacy of Individual Rights (PAIR)
Program Performance Report (SC)
FORMS: RSA-509
OMB NO: 1820-0632 EXPIRATION DATE: 06/30/2003
RESPS:32,138 HOURS:17,049 COSTS(000):$0
Special Education Elementary Longitudinal Study (Seels)
FORMS: NONE
OMB NO: 1820-0633 EXPIRATION DATE: 04/30/2003
RESPS:5,595 HOURS:11,262 COSTS(000):$0
State and Local Implementation of IDEA '97
FORMS: NONE
OMB NO: 1820-0634 EXPIRATION DATE: 10/31/2003
RESPS:57 HOURS:1,680 COSTS(000):$39
Alternative Financing Program and the Alternate Financing
FORMS: NONE
OMB NO: 1820-0635 EXPIRATION DATE: 10/31/2005
RESPS:17,347 HOURS:8,965 COSTS(000):$0
National Longitudinal Transition Study-2 (NLTS2)
FORMS: NONE
OMB NO: 1820-0636 EXPIRATION DATE: 12/31/2003
RESPS:464 HOURS:684 COSTS(000):$0
Evaluation of the American Indian Vocational Rehabilitation
Services (AIVRS) Program (SC)
FORMS: NONE
OMB NO: 1820-0637 EXPIRATION DATE: 12/31/2003
RESPS:300 HOURS:100 COSTS(000):$0
NIDRR Quality of Research Rating Scale
FORMS: NONE
OMB NO: 1820-0640 EXPIRATION DATE: 03/31/2004
RESPS:1,003 HOURS:1,575 COSTS(000):$0
Evaluation of Independent Living Programs (SC)
FORMS: NONE
OMB NO: 1820-0642 EXPIRATION DATE: 02/29/2004
RESPS:193 HOURS:3,088 COSTS(000):$0
Annual Performance Reporting Forms for NIDRR Grantees (RERCs,
RRTCs, DBTACs, DRRPs, Model Systems, Dissemination &
Utillization Projects) (SC)
FORMS: NONE
OMB NO: 1820-0644 EXPIRATION DATE: 07/31/2004
RESPS:58 HOURS:18,312 COSTS(000):$0
Consolidated Data Collection on Students with Disabilities (SC)
FORMS: NONE
OMB NO: 1820-0646 EXPIRATION DATE: 09/30/2004
RESPS:73 HOURS:2,044 COSTS(000):$0
Annual Progress Reporting Form for Special Demonstration
Programs (SC)
FORMS: NONE
OMB NO: 1820-0649 EXPIRATION DATE: 01/31/2004
RESPS:135 HOURS:333 COSTS(000):$0
An Evaluation of the State Program Improvement Grant (SIG)
Program
FORMS: NONE
OMB NO: 1820-0650 EXPIRATION DATE: 04/30/2005
RESPS:462 HOURS:498 COSTS(000):$0
Evaluation of the Projects With Industry (PWI) Program
FORMS: NONE
OMB NO: 1820-0655 EXPIRATION DATE: 01/31/2005
RESPS:66 HOURS:1,056 COSTS(000):$0
Annual Progress Reporting Form for the American Indian
Vocational Rehabilitation Services (AIVRS) Program
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
49 1,353,687 1,967,741 $105,049
Office of Vocational and Adult Education
OMB NO: 1830-0029 EXPIRATION DATE: 04/30/2003
RESPS:56 HOURS:12,208 COSTS(000):$0
Carl D. Perkins Vocational and Technical Education
FORMS: NONE
OMB NO: 1830-0503 EXPIRATION DATE: 04/30/2004
RESPS:54 HOURS:6,845 COSTS(000):$526
Vocational Technical Education Annual Performance and Financial
Reports (SC)
FORMS: NONE
OMB NO: 1830-0537 EXPIRATION DATE: 04/30/2003
RESPS:689 HOURS:669 COSTS(000):$0
National Survey to Determine the Need for Special Education
Services (JM)
FORMS: NONE
OMB NO: 1830-0541 EXPIRATION DATE: 05/31/2003
RESPS:59 HOURS:2,124 COSTS(000):$0
Carl D. Perkins Vocational and Technical Education
Act--Occupational and Employment Information State Grants
(Section 118, PL 105-332) (1890-0001) (SC)
FORMS: CFDA#84.346
OMB NO: 1830-0542 EXPIRATION DATE: 09/30/2003
RESPS:639 HOURS:75,632 COSTS(000):$0
Application for Vocational and Technical Education Direct Grants
(1890-0001) (SC)
FORMS: NONE
OMB NO: 1830-0544 EXPIRATION DATE: 11/30/2003
RESPS:38 HOURS:95 COSTS(000):$0
Indian Vocational Education Program Technology Survey
FORMS: NONE
OMB NO: 1830-0546 EXPIRATION DATE: 11/30/2003
RESPS:11 HOURS:440 COSTS(000):$0
Career Cluster Cooperative Agreements with States
FORMS: NONE
OMB NO: 1830-0548 EXPIRATION DATE: 01/31/2004
RESPS:59 HOURS:4,720 COSTS(000):$0
America's Career Resource Network State Grants Annual
Performance Reports
FORMS: NONE
OMB NO: 1830-0549 EXPIRATION DATE: 02/29/2004
RESPS:1,049 HOURS:831 COSTS(000):$0
New American High Schools Implementation Study
FORMS: NONE
OMB NO: 1830-0550 EXPIRATION DATE: 02/29/2004
RESPS:50 HOURS:2,400 COSTS(000):$0
Tech-Prep Demonstration Grants (1890-0001)(SC)
FORMS: NONE
OMB NO: 1830-0551 EXPIRATION DATE: 06/30/2004
RESPS:20 HOURS:1,000 COSTS(000):$0
High School Reform State Grants (1890-0001) (SC)
FORMS: NONE
OMB NO: 1830-0552 EXPIRATION DATE: 02/29/2004
RESPS:700 HOURS:47,000 COSTS(000):$0
The Smaller Learning Communities Program (SLC) (1890-0001) (SC)
FORMS: NONE
OMB NO: 1830-0553 EXPIRATION DATE: 10/31/2003
RESPS:161 HOURS:1,288 COSTS(000):$0
Annual Performance Report for the Smaller Learning Communities
Grant Program
FORMS: CFDA#:84.215L
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
13 3,585 155,252 $526
Office of Postsecondary Education
OMB NO: 1840-0005 EXPIRATION DATE: 06/30/2004
RESPS:670 HOURS:12,560 COSTS(000):$0
Fulbright-Hays Training Grants Faculty Research Abroad Program -
CFDA 84.019 Doctoral Dissertation Research Abroad Program - CFDA
84.022
FORMS: NONE
OMB NO: 1840-0007 EXPIRATION DATE: 06/30/2003
RESPS:370 HOURS:30,200 COSTS(000):$0
Grant Application under the Teacher Quality Enhancement Grants,
for the preparation of applications for: Partnership Grants.....
FORMS: NONE
OMB NO: 1840-0017 EXPIRATION DATE: 06/30/2003
RESPS:1,200 HOURS:40,800 COSTS(000):$0
Application for Grants under Student Support Services Program
FORMS: NONE
OMB NO: 1840-0065 EXPIRATION DATE: 06/30/2004
RESPS:1,300 HOURS:44,200 COSTS(000):$0
Application for Grants Under Talent Search and Educational
Opportunity Centers Programs
FORMS: NONE
OMB NO: 1840-0068 EXPIRATION DATE: 06/30/2004
RESPS:528 HOURS:38,550 COSTS(000):$0
Applications for Title VI International Education Programs
FORMS: CFDA-84.153 84.021 84.017 84.016 84.15A 84.15B 84.274 84.229
OMB NO: 1840-0103 EXPIRATION DATE: 10/31/2004
RESPS:1 HOURS:8,400 COSTS(000):$0
Application for Designation as an Eligible Institution
(1890-0001) for Title III and V
FORMS: 1049
OMB NO: 1840-0109 EXPIRATION DATE: 02/28/2005
RESPS:200 HOURS:8,000 COSTS(000):$0
Application for Grants Under the Minority Science and
Engineering Improvement Program (1890-0001) (JS)
FORMS: NONE
OMB NO: 1840-0113 EXPIRATION DATE: 11/30/2003
RESPS:117 HOURS:889 COSTS(000):$0
Application for Strengthening Historically Black Colleges and
Universities Program and Historically Black Graduate
Institutions Program (JS)
FORMS: ED-852
OMB NO: 1840-0130 EXPIRATION DATE: 03/31/2006
RESPS:1 HOURS:6,983 COSTS(000):$0
Teacher Cancellation Low Income Directory (JS)
FORMS: CFDA-34.674
OMB NO: 1840-0501 EXPIRATION DATE: 07/31/2003
RESPS:500 HOURS:2,000 COSTS(000):$0
Fulbright-Hays Seminars Abroad Program
FORMS: CFDA#84.018
OMB NO: 1840-0507 EXPIRATION DATE: 08/31/2004
RESPS:25 HOURS:113 COSTS(000):$0
Performance Report for the Training Programs for Federal TRIO
Programs
FORMS: CFDA#84.103
OMB NO: 1840-0514 EXPIRATION DATE: 12/31/2003
RESPS:1,650 HOURS:19,500 COSTS(000):$0
FIPSE Comprehensive Program Grant Application
FORMS: 84.116A=CFDA 84.116B=CFDA
OMB NO: 1840-0525 EXPIRATION DATE: 10/31/2003
RESPS:1 HOURS:3,060 COSTS(000):$0
Annual Performance Report for the Student Support Services
Program (JS)
FORMS: 84.042A
OMB NO: 1840-0550 EXPIRATION DATE: 08/31/2005
RESPS:483 HOURS:16,422 COSTS(000):$0
Application for Grants under Upward Bound (UB) & Upward Bound
Math/Sciencer (UBMS) Programs (1890-00001) (JS)
FORMS: NONE
OMB NO: 1840-0562 EXPIRATION DATE: 04/30/2003
RESPS:2,000 HOURS:10,000 COSTS(000):$0
Application Package for the Jacob K. Javits Fellowship Program
FORMS: NONE
OMB NO: 1840-0564 EXPIRATION DATE: 07/31/2003
RESPS:330 HOURS:990 COSTS(000):$0
Financial Report for the Endowment Challenge Grant Program
FORMS: NONE
OMB NO: 1840-0595 EXPIRATION DATE: 08/31/2003
RESPS:57 HOURS:456 COSTS(000):$0
Paul Douglas Teacher Scholarship Program Performance Report
FORMS: 40-31P CFDA#84.176
OMB NO: 1840-0604 EXPIRATION DATE: 08/31/2003
RESPS:325 HOURS:13,432 COSTS(000):$0
Application Package for the Graduate Assistance in Areas of
National Need (GAANN) Fellowship Program
FORMS: CFDA=84.200
OMB NO: 1840-0616 EXPIRATION DATE: 06/30/2004
RESPS:50 HOURS:750 COSTS(000):$0
Application for Centers for International Business Education
Program
FORMS: CFDA-84.220
OMB NO: 1840-0617 EXPIRATION DATE: 09/30/2003
RESPS:57 HOURS:4,580 COSTS(000):$0
Targeted Teacher Deferment (Teacher Shortage Area)
FORMS: NONE
OMB NO: 1840-0619 EXPIRATION DATE: 07/31/2005
RESPS:300 HOURS:1,500 COSTS(000):$0
Application for Grants Under Ronald E. McMair Postbaccalaureate
Achievement Program
FORMS: NONE
OMB NO: 1840-0630 EXPIRATION DATE: 08/31/2004
RESPS:100 HOURS:400 COSTS(000):$8,000
Report of Financial Need and Certification for the Jacob K.
Javits Fellowship Program
FORMS: 40-1304 CFDA#84.170
OMB NO: 1840-0636 EXPIRATION DATE: 02/29/2004
RESPS:80 HOURS:2,400 COSTS(000):$0
European Community/United States of America Cooperation Program
in Higher Education and Vocational Education and Training
FORMS: ED40-514
OMB NO: 1840-0640 EXPIRATION DATE: 07/31/2003
RESPS:1 HOURS:702 COSTS(000):$17,160
Performance Report for the Ronald E. McNair Postbaccalaureate
Achievement Program
FORMS: CFDA-84.217
OMB NO: 1840-0702 EXPIRATION DATE: 08/31/2005
RESPS:20 HOURS:600 COSTS(000):$0
The Program for North American Mobility in Higher Education (JS)
FORMS: NONE
OMB NO: 1840-0729 EXPIRATION DATE: 08/31/2003
RESPS:30 HOURS:150 COSTS(000):$0
Final Performance Report for the Business in International
Education Program
FORMS: NONE
OMB NO: 1840-0737 EXPIRATION DATE: 12/31/2005
RESPS:1 HOURS:9,000 COSTS(000):$0
Child Care Access Means Parents in School (CCAMPIS) Program - A
Guide for the Preparation of Applications
FORMS: CFDA-84.335A
OMB NO: 1840-0738 EXPIRATION DATE: 05/31/2005
RESPS:75 HOURS:2,250 COSTS(000):$0
Application Demonstration Projects for Faculty Training in
Disability Issues (1890-0001)
FORMS: 84.333
OMB NO: 1840-0740 EXPIRATION DATE: 04/30/2003
RESPS:300 HOURS:18,000 COSTS(000):$0
Application Package for Gaining Early Awareness and Readiness for
FORMS: NONE
OMB NO: 1840-0744 EXPIRATION DATE: 04/30/2003
RESPS:1,250 HOURS:127,624 COSTS(000):$3,757
Reference and Reporting Guide for Preparing State and
Institutional Reports on Teacher Quality and Preparation
FORMS: NONE
OMB NO: 1840-0746 EXPIRATION DATE: 12/31/2003
RESPS:50 HOURS:500 COSTS(000):$0
Application for Grants Under the TRIO Dissemination Partnership
Program (84.344) (1890-0001) (JS)
FORMS: 84.344
OMB NO: 1840-0748 EXPIRATION DATE: 03/31/2006
RESPS:1 HOURS:2,250 COSTS(000):$0
Graduate Assistance in Areas of National Need Performance Report
FORMS: NONE
OMB NO: 1840-0750 EXPIRATION DATE: 08/31/2004
RESPS:30,544 HOURS:6,340 COSTS(000):$0
Distance Education Demonstration Program Annual Reporting Form
FORMS: NONE
OMB NO: 1840-0755 EXPIRATION DATE: 05/31/2003
RESPS:100 HOURS:6,000 COSTS(000):$0
Application for Grants Under the Community Scholarship
Mobilization Program
FORMS: CFDA#84.347
OMB NO: 1840-0756 EXPIRATION DATE: 05/31/2003
RESPS:20 HOURS:400 COSTS(000):$0
First and Second Year Annual Progress Reports for the European
Community/US Joint Consortia Program
FORMS: ED-514
OMB NO: 1840-0757 EXPIRATION DATE: 10/31/2004
RESPS:40 HOURS:1,600 COSTS(000):$0
Learning Anytime Anywhere Partnerships (LAAP) Guidelines for
Annual Performance Reports with Auxiliary Collection Instruments
(JS)
FORMS: NONE
OMB NO: 1840-0758 EXPIRATION DATE: 07/31/2003
RESPS:140 HOURS:2,800 COSTS(000):$0
Comprehensive Program Annual Performance Report
FORMS: ED524-B
OMB NO: 1840-0759 EXPIRATION DATE: 02/28/2005
RESPS:1,411 HOURS:18,242 COSTS(000):$0
The Evaluation of Exchange, Language, International and Area
Studies (EELIAS), NRC, FLAS and IIPP, UISFUL, Business and
International Education Program (BIE), Centers for..............
FORMS: NONE
OMB NO: 1840-0760 EXPIRATION DATE: 07/31/2003
RESPS:60 HOURS:1,200 COSTS(000):$0
Annual Reporting Forms for the Program for North American
Mobility in Higher Education
FORMS: NONE
OMB NO: 1840-0761 EXPIRATION DATE: 10/31/2003
RESPS:80 HOURS:2,400 COSTS(000):$0
The US-Brazil Higher Education Consortia Program Application for
the US-Brazil Higher Education Consortia Program
FORMS: CFDA-84.116
OMB NO: 1840-0762 EXPIRATION DATE: 01/31/2004
RESPS:1 HOURS:13,500 COSTS(000):$104
Annual Performance Report for the Upward Bound, Upward Bound
Math/Science, and Veterans Upward Bound Programs
FORMS: NONE
OMB NO: 1840-0763 EXPIRATION DATE: 02/29/2004
RESPS:1 HOURS:609 COSTS(000):$0
18 and 36 months Performance Reports for the Child Care Access
Parents in Schools Program
FORMS: NONE
OMB NO: 1840-0764 EXPIRATION DATE: 08/31/2004
RESPS:1 HOURS:2,000 COSTS(000):$0
Final Performance Report for Grants Under Title III -
Institutional Aid Programs
FORMS: CFDA#S-84.031A 84.031B 84.031N 84.031S 84.031T 84.031W 84.120A
OMB NO: 1840-0766 EXPIRATION DATE: 04/30/2005
RESPS:631 HOURS:11,358 COSTS(000):$0
Annual Performance Report for Title III and Title V Grantees
FORMS: 84.031A 84.031T 84.031N 84.031S 84.031W 84.120A
OMB NO: 1840-0767 EXPIRATION DATE: 06/30/2005
RESPS:125 HOURS:20,000 COSTS(000):$0
Teacher Recruitment Application Package
FORMS: NONE
OMB NO: 1840-0769 EXPIRATION DATE: 11/30/2005
RESPS:15 HOURS:525 COSTS(000):$0
Final Performance Report Guidelines for the Learning Anytine
Anywhere Parternships (LAAP) Program (JS)
FORMS: 84.339
OMB NO: 1840-0770 EXPIRATION DATE: 11/30/2005
RESPS:35 HOURS:700 COSTS(000):$0
Final Reporting Forms for FIPSE International Consortia Programs
FORMS: 84.116J 84.116M 84.116N
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
47 45,277 514,935 $29,021
Office of Federal Student Aid
OMB NO: 1845-0001 EXPIRATION DATE: 10/31/2005
RESPS:13,726,803 HOURS:7,680,346 COSTS(000):$0
Free Application for Federal Student Aid (FAFSA)
FORMS: ED-255
OMB NO: 1845-0002 EXPIRATION DATE: 08/31/2003
RESPS:4,660 HOURS:2,151 COSTS(000):$35
Student Aid Internet Gateway (SAIG) Enrollment form
FORMS: NONE
OMB NO: 1845-0003 EXPIRATION DATE: 01/31/2006
RESPS:61 HOURS:1,036 COSTS(000):$0
Application for 34 CFR Part 602 The Secretary's Recognition of
Accrediting Agencies (JS)
FORMS: NONE
OMB NO: 1845-0004 EXPIRATION DATE: 12/31/2003
RESPS:10,300 HOURS:228,150 COSTS(000):$0
Student Right-to-Know Act (SRK)
FORMS: NONE
OMB NO: 1845-0005 EXPIRATION DATE: 09/30/2005
RESPS:1,148,819 HOURS:183,811 COSTS(000):$0
FFEL Deferment Requests (JS)
FORMS: NONE
OMB NO: 1845-0006 EXPIRATION DATE: 09/30/2005
RESPS:2,887,200 HOURS:2,165,400 COSTS(000):$0
Federal Stafford Loan (Subsidized and Unsubsidized) Program
Master Promissory Note (JS)
FORMS: CFDA=84.032
OMB NO: 1845-0007 EXPIRATION DATE: 10/31/2005
RESPS:706,000 HOURS:353,000 COSTS(000):$0
Federal Direct Stafford/Ford Loan and Federal Direct
Unsubsidized Stafford/Ford Loan Master Promissory Note
FORMS: NONE
OMB NO: 1845-0008 EXPIRATION DATE: 12/31/2004
RESPS:20,524,631 HOURS:4,871,526 COSTS(000):$0
Student Aid Report (SAR)
FORMS: ED-255-1
OMB NO: 1845-0009 EXPIRATION DATE: 10/31/2004
RESPS:100,000 HOURS:50,000 COSTS(000):$0
Federal PLUS Loan Program Application Documents (JS)
FORMS: NONE
OMB NO: 1845-0010 EXPIRATION DATE: 02/28/2006
RESPS:1,800 HOURS:9,900 COSTS(000):$0
Regulations for Equity in Athletics Disclosure Act (EADA) (JS)
FORMS: NONE
OMB NO: 1845-0011 EXPIRATION DATE: 06/30/2005
RESPS:1 HOURS:143,030 COSTS(000):$0
William D. Ford Federal Direct Loan Program Deferment Request
Forms
FORMS: NONE
OMB NO: 1845-0012 EXPIRATION DATE: 10/31/2005
RESPS:2,970 HOURS:20,830 COSTS(000):$0
Application for Approval to Participate in Federal Student
Financial Aid Programs
FORMS: E40-34P CFDA:84.007 84.032 84.033 84.063 84.038 84.268
OMB NO: 1845-0013 EXPIRATION DATE: 08/31/2003
RESPS:17,200 HOURS:41,925 COSTS(000):$0
Lender's Request for Payment of Interest and Special Allowance
(JS)
FORMS: ED-799
OMB NO: 1845-0014 EXPIRATION DATE: 11/30/2004
RESPS:1,927,000 HOURS:635,910 COSTS(000):$0
William D. Ford Federal Direct Loan Program Repayment Plan
Selection Form (JS)
FORMS: NONE
OMB NO: 1845-0015 EXPIRATION DATE: 06/30/2005
RESPS:55,200 HOURS:27,600 COSTS(000):$0
Federal Family Education Loan, Direct Loan, and Perkins Loan
Discharge Applications (JS)
FORMS: NONE
OMB NO: 1845-0016 EXPIRATION DATE: 01/31/2006
RESPS:690,685 HOURS:227,927 COSTS(000):$0
Direct Loan Income Contingent Repayment Plan Alternative
Documentation of Income (LO)
FORMS: 84.268
OMB NO: 1845-0017 EXPIRATION DATE: 01/31/2006
RESPS:314,861 HOURS:62,972 COSTS(000):$0
Direct Loan Income Contingent Repayment Plan - Consent to
Disclosure of Tax Information (LO)
FORMS: 84.268
OMB NO: 1845-0018 EXPIRATION DATE: 01/31/2006
RESPS:4,092 HOURS:818 COSTS(000):$0
William D. Ford Federal Direct Loan Program Statutory
Forbearance Forms (LO)
FORMS: NONE
OMB NO: 1845-0019 EXPIRATION DATE: 10/31/2005
RESPS:95,262 HOURS:25,859 COSTS(000):$0
Federal Perkins Loan Program Regulations and General Provision
Regulations
FORMS: CFDA=84.038
OMB NO: 1845-0020 EXPIRATION DATE: 10/31/2005
RESPS:858,981 HOURS:10,128,562 COSTS(000):$1,253
Federal Family Education Loan Program Regulations
FORMS: CFDA-84.032
OMB NO: 1845-0021 EXPIRATION DATE: 10/31/2005
RESPS:846,034 HOURS:211,520 COSTS(000):$0
William D. Ford Federal Direct Loan Program
FORMS: CFDA=84.0268
OMB NO: 1845-0022 EXPIRATION DATE: 10/31/2005
RESPS:93,877 HOURS:1,209,890 COSTS(000):$5,040
Cohort Default Rates for Institutions Participating in the FFEL
or Direct Loan Programs
FORMS: NONE
OMB NO: 1845-0023 EXPIRATION DATE: 10/31/2005
RESPS:2,800,642 HOURS:61,879 COSTS(000):$0
Federal Perkins Loan Program Regulations
FORMS: CFDA=84.037
OMB NO: 1845-0026 EXPIRATION DATE: 03/31/2004
RESPS:612 HOURS:33,660 COSTS(000):$0
Guaranty Agency Financial Report (JS)
FORMS: 2000
OMB NO: 1845-0028 EXPIRATION DATE: 07/31/2004
RESPS:56 HOURS:112 COSTS(000):$0
The joint application for the Leveraging Educational Assistance
Partnership and Special LEAP Programs
FORMS: ED-1288
OMB NO: 1845-0030 EXPIRATION DATE: 04/30/2004
RESPS:1 HOURS:26,280 COSTS(000):$0
Fiscal Operations Report and Application to Participate (FISAP)
Opportunity Grant and Federal Work-Study Programs
FORMS: ED-646-1
OMB NO: 1845-0031 EXPIRATION DATE: 04/30/2003
RESPS:660,000 HOURS:132,000 COSTS(000):$0
William D. Ford Federal Direct Loan Program General Forberance
Request Form
FORMS: NONE
OMB NO: 1845-0032 EXPIRATION DATE: 02/28/2006
RESPS:121 HOURS:20 COSTS(000):$0
Lender's Application Process (LAP) (JS)
FORMS: NONE
OMB NO: 1845-0035 EXPIRATION DATE: 05/31/2003
RESPS:29,952 HOURS:179,712 COSTS(000):$72
National Student Loan Data System (NSLDS)
FORMS: NONE
OMB NO: 1845-0036 EXPIRATION DATE: 06/30/2003
RESPS:263,000 HOURS:263,000 COSTS(000):$0
Federal Family Education Loan Program Federal Consolidation Loan
Application and Promissory Note
FORMS: NONE
OMB NO: 1845-0038 EXPIRATION DATE: 10/31/2005
RESPS:6,576 HOURS:1,218,718 COSTS(000):$101
Student Assistance General Provisions - Subpart K - Cash
Management (JS)
FORMS: NONE
OMB NO: 1845-0039 EXPIRATION DATE: 06/30/2003
RESPS:3,950,083 HOURS:396,200 COSTS(000):$2,959
Federal Pell Grant Program Recipient Financial Management System
(RFMS)
FORMS: CFDA#84.063
OMB NO: 1845-0040 EXPIRATION DATE: 02/28/2005
RESPS:210,000 HOURS:6,993 COSTS(000):$0
William D. Ford Federal Direct Loan (Direct Loan) Program
Electronic Debit Account Application and Brochure (JS)
FORMS: NONE
OMB NO: 1845-0041 EXPIRATION DATE: 06/30/2004
RESPS:1 HOURS:354,453 COSTS(000):$65,000
Student Assistance General Provisions - Subpart E (Verification
of Student Aid Application Information)
FORMS: NONE
OMB NO: 1845-0042 EXPIRATION DATE: 02/28/2005
RESPS:1,804 HOURS:487 COSTS(000):$0
Lender's Application for Payment of Insurance Claim
FORMS: ED-1207
OMB NO: 1845-0044 EXPIRATION DATE: 03/31/2005
RESPS:56 HOURS:560 COSTS(000):$0
The Leveraging Educational Assistance Partnership (LEAP) and
Special Leveraging Educational Assistance Partnership (SLEAP)
Programs
FORMS: ED-FORM-1288-1 CFDA-84.069A-B
OMB NO: 1845-0045 EXPIRATION DATE: 01/31/2004
RESPS:1 HOURS:6,000 COSTS(000):$0
Clearance Package for OSFA customer Satisfaction Survey Master
Plan
FORMS: NONE
OMB NO: 1845-0046 EXPIRATION DATE: 08/31/2004
RESPS:9,804 HOURS:10,621 COSTS(000):$0
Consolidation Loan Rebate Fee Report
FORMS: ED-4-619
OMB NO: 1845-0047 EXPIRATION DATE: 08/31/2004
RESPS:300,000 HOURS:75,000 COSTS(000):$0
Income Contingent Repayment Plan Consent to Disclosure of Tax
Information
FORMS: NONE
OMB NO: 1845-0048 EXPIRATION DATE: 04/30/2003
RESPS:21,262 HOURS:10,631 COSTS(000):$0
Federal Perkins/NDSL Loan Assignment form (JS)
FORMS: ED-553 CFDA#84.038
OMB NO: 1845-0049 EXPIRATION DATE: 10/31/2005
RESPS:150,021 HOURS:75,450 COSTS(000):$0
Application for Ability to Benefit Testing Approval (JS)
FORMS: CFDA#84.032 84.063 84.268
OMB NO: 1845-0051 EXPIRATION DATE: 04/30/2003
RESPS:81,458 HOURS:40,729 COSTS(000):$55
Federal Direct PLUS Loan Application and Promissory Note
FORMS: NONE
OMB NO: 1845-0052 EXPIRATION DATE: 04/30/2005
RESPS:93,837 HOURS:23,209 COSTS(000):$71
Student Assistance General Provisions--Subpart I--Immigration
Status Confirmation
FORMS: NONE
OMB NO: 1845-0053 EXPIRATION DATE: 01/31/2005
RESPS:1,028,500 HOURS:681,875 COSTS(000):$0
Federal Direct Coonsolidation Loan Program Application Documents
(JS)
FORMS: NONE
OMB NO: 1845-0054 EXPIRATION DATE: 10/31/2004
RESPS:500 HOURS:2,500 COSTS(000):$0
Notice Inviting Proposals for Participation in the Experimental
Sites Initiative (JS)
FORMS: 84.07 84.032 84.033 84.063 84.038 84.268
OMB NO: 1845-0055 EXPIRATION DATE: 10/31/2004
RESPS:125 HOURS:125 COSTS(000):$0
Federal Register Notice Inviting Applications for Participation
in the Quality Assurance Program
FORMS: NONE
OMB NO: 1845-0057 EXPIRATION DATE: 06/30/2005
RESPS:2,790 HOURS:618 COSTS(000):$0
Child Care Provider Loan Forgiveness Application and Forgiveness
Forbearance form (JS)
FORMS: NONE
OMB NO: 1845-0058 EXPIRATION DATE: 10/31/2004
RESPS:600 HOURS:300 COSTS(000):$0
Loan Discharge Application: Unpaid Refund
FORMS: NONE
OMB NO: 1845-0059 EXPIRATION DATE: 10/31/2004
RESPS:21,425 HOURS:6,929 COSTS(000):$0
Federal Direct Loan Program and Federal Family Education Loan
Program Teacher Loan Forgiveness Form
FORMS: NONE
OMB NO: 1845-0060 EXPIRATION DATE: 04/30/2003
RESPS:20,365 HOURS:10,183 COSTS(000):$0
Endorser Addendum to Federal Direct PLUS Loan Application and
Promissory Note (JS)
FORMS: NONE
OMB NO: 1845-0061 EXPIRATION DATE: 10/31/2004
RESPS:690,000 HOURS:345,000 COSTS(000):$0
Federal Perkins Loan/NDSL Promissory Notes
FORMS: CFDA#84-038
OMB NO: 1845-0065 EXPIRATION DATE: 12/31/2005
RESPS:15,000 HOURS:7,500 COSTS(000):$0
Federal Family Education Loan, Direct Loan, and Perkins Loan
Discharge Applications (JS)
FORMS: CFDA=84.032 84.268 84.037
OMB NO: 1845-0066 EXPIRATION DATE: 06/30/2005
RESPS:150 HOURS:1,650 COSTS(000):$0
Experimental Sites Initiative - Data Collection Instrument (JS)
FORMS: CFDA84.032(FFEL 84.038(PERKINS) 84.033(FWS) 84.063(PELL)
84.268(DL)
OMB NO: 1845-0068 EXPIRATION DATE: 01/31/2006
RESPS:225,000 HOURS:112,500 COSTS(000):$0
Federal Direct PLUS Loan Application and Master Promissory Note
(PLUS MPN), and Endorser Addendum
FORMS: NONE
OMB NO: 1845-0069 EXPIRATION DATE: 01/31/2006
RESPS:33,333 HOURS:16,667 COSTS(000):$0
Federal PLUS Program Maser Promissory Note (JS)
FORMS: CFDA-84.032
OMB NO: 1845-0072 EXPIRATION DATE: 09/30/2003
RESPS:4,000 HOURS:4,000 COSTS(000):$200
eZ-Audit: Electronic Submission of Financial Statements and
Compliance Audits
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
56 54,637,512 32,387,724 $74,786
Institute of Education Sciences
OMB NO: 1850-0067 EXPIRATION DATE: 11/30/2004
RESPS:284 HOURS:11,004 COSTS(000):$0
Common Core of Data Surveys
FORMS: NONE
OMB NO: 1850-0582 EXPIRATION DATE: 04/30/2003
RESPS:60,282 HOURS:202,636 COSTS(000):$0
Integrated Postsecondary Education Data System (IPEDS),
Introduction of the Web-Based Collection on Institutional Price
& Student Financial Aid and modifications to the 2000-2002
data....
FORMS: NONE
OMB NO: 1850-0598 EXPIRATION DATE: 08/31/2004
RESPS:2,764 HOURS:2,232 COSTS(000):$0
Field test activities and the 2003-2004 full-scale Schools and
Staffing Survey (SASS): LEA, Principal, School, Teacher, Library
FORMS: NONE
OMB NO: 1850-0601 EXPIRATION DATE: 05/31/2003
RESPS:750 HOURS:11,250 COSTS(000):$0
Application for the Field-Initiated Studies Educational Research
Grant Program
FORMS: NONE
OMB NO: 1850-0608 EXPIRATION DATE: 02/29/2004
RESPS:1,200 HOURS:531 COSTS(000):$0
National Survey of Postsecondary Faculty: 2004 (NSOPF:04) --
Faculty Survey (KI)
FORMS: NONE
OMB NO: 1850-0617 EXPIRATION DATE: 05/31/2003
RESPS:18,279 HOURS:4,616 COSTS(000):$0
2000-01 Teacher Follow-up Survey
FORMS: NONE
OMB NO: 1850-0628 EXPIRATION DATE: 02/28/2006
RESPS:658,800 HOURS:169,101 COSTS(000):$0
National Assessment of Educational Progress 2003 Charter Schools
Questions
FORMS: NONE
OMB NO: 1850-0631 EXPIRATION DATE: 04/30/2003
RESPS:569 HOURS:224 COSTS(000):$0
Beginning Postsecondary Students Longitudinal Study 1996-2001
(BPS: 1996/2001)
FORMS: NONE
OMB NO: 1850-0645 EXPIRATION DATE: 03/31/2004
RESPS:6,900 HOURS:3,885 COSTS(000):$0
IEA Progress in International Reading Literacy Study
FORMS: NONE
OMB NO: 1850-0652 EXPIRATION DATE: 12/31/2005
RESPS:1,270 HOURS:941 COSTS(000):$0
Education Longitudinal Study of 2002, First Followup
FORMS: NONE
OMB NO: 1850-0654 EXPIRATION DATE: 06/30/2004
RESPS:13,000 HOURS:5,850 COSTS(000):$0
National Assessment of Adult Literacy
FORMS: NONE
OMB NO: 1850-0665 EXPIRATION DATE: 08/31/2005
RESPS:150 HOURS:446 COSTS(000):$0
2004 National Survey of Postsecondary Faculty (NSOPF:04): List
Collection Procedures and Institution Questionnaire (KA)
FORMS: NONE
OMB NO: 1850-0666 EXPIRATION DATE: 06/30/2004
RESPS:1,204 HOURS:4,125 COSTS(000):$0
National Postsecondary Student Aid Study: 2004
FORMS: NONE
OMB NO: 1850-0689 EXPIRATION DATE: 06/30/2005
RESPS:56 HOURS:2,520 COSTS(000):$0
Public Libraries Survey, 2002-2004
FORMS: NONE
OMB NO: 1850-0695 EXPIRATION DATE: 02/28/2006
RESPS:25,710 HOURS:20,730 COSTS(000):$0
Trends in International Mathematics and Science Study (TIMSS):
2003 (KA)
FORMS: NONE
OMB NO: 1850-0705 EXPIRATION DATE: 06/30/2005
RESPS:51 HOURS:561 COSTS(000):$0
State Library Agencies Survey
FORMS: NONE
OMB NO: 1850-0729 EXPIRATION DATE: 03/31/2005
RESPS:10,063 HOURS:4,081 COSTS(000):$0
Baccalaureate and Beyond Longitudinal Study, Third Followup
(B&B:93/2003)
FORMS: NONE
OMB NO: 1850-0733 EXPIRATION DATE: 10/31/2003
RESPS:10,518 HOURS:7,889 COSTS(000):$0
NCES Quick Response Information System (KA)
FORMS: NONE
OMB NO: 1850-0746 EXPIRATION DATE: 05/31/2004
RESPS:1 HOURS:1 COSTS(000):$0
Standards for Evaluation of the Performance of Recipients of
OERI Grants, Cooperative Agreements, and Contracts
FORMS: NONE
OMB NO: 1850-0750 EXPIRATION DATE: 02/28/2005
RESPS:22,253 HOURS:14,990 COSTS(000):$0
Early Childhood Longitudinal Study (ECLS) - Kindergarten cohort,
third grade followup, field test for fourth and fifth grade
survey activities
FORMS: NONE
OMB NO: 1850-0755 EXPIRATION DATE: 06/30/2004
RESPS:10,800 HOURS:29,875 COSTS(000):$0
Program for International Student Assessment (PISA)
FORMS: NONE
OMB NO: 1850-0756 EXPIRATION DATE: 11/30/2005
RESPS:31,364 HOURS:23,114 COSTS(000):$0
Early Childhood Longitudinal Study: Birth Cohort/24 Month
Followup (KI)
FORMS: NONE
OMB NO: 1850-0758 EXPIRATION DATE: 10/31/2004
RESPS:97,750 HOURS:24,500 COSTS(000):$0
National Assessment of Educational Progress, 2002 Field Test and
2003 Full Scale Assessment of Reading, Math, and Foreign Language
FORMS: NONE
OMB NO: 1850-0763 EXPIRATION DATE: 04/30/2003
RESPS:80 HOURS:9,600 COSTS(000):$0
Application for a Comprehensive School Reform Educational
Research Grant
FORMS: NONE
OMB NO: 1850-0768 EXPIRATION DATE: 02/28/2005
RESPS:62,627 HOURS:10,750 COSTS(000):$0
National Househld Education Surveys Program of 2003 (NHES: 2003)
FORMS: NONE
OMB NO: 1850-0769 EXPIRATION DATE: 09/30/2003
RESPS:36,253 HOURS:15,721 COSTS(000):$0
The Impact of ICT on Learning: Quasi-Experimental Study
FORMS: NONE
OMB NO: 1850-0771 EXPIRATION DATE: 12/31/2003
RESPS:5,750 HOURS:1,438 COSTS(000):$0
NAEP Technology Based Assessment Project, Pretest and Field Test
FORMS: NONE
OMB NO: 1850-0776 EXPIRATION DATE: 12/31/2003
RESPS:1,500 HOURS:4,500 COSTS(000):$0
International Adult Literacy and Lifeskills Survey (KI)
FORMS: NONE
OMB NO: 1850-0781 EXPIRATION DATE: 08/31/2005
RESPS:3,400 HOURS:5,950 COSTS(000):$0
Academic Libraries Survey: 2002-2005 (KA)
FORMS: NONE
OMB NO: 1850-0783 EXPIRATION DATE: 11/30/2005
RESPS:8,791 HOURS:5,242 COSTS(000):$0
Preschool Curricula Evaluation Research (PCER) Program
FORMS: NONE
OMB NO: 1850-0784 EXPIRATION DATE: 03/31/2006
RESPS:3,500 HOURS:1,155 COSTS(000):$46,200
Even Start and Title I Preschool Classroom Literacy Environment
and Outcomes Study (JM)
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
31 1,095,919 599,458 $46,200
Office of Innovation and Improvement
OMB NO: 1855-0001 EXPIRATION DATE: 05/31/2005
RESPS:30 HOURS:720 COSTS(000):$0
Application for Grants, Public Charter Schools Program
(1890-0001) (KA)
FORMS: NONE
OMB NO: 1855-0002 EXPIRATION DATE: 05/31/2005
RESPS:200 HOURS:8,000 COSTS(000):$0
Parental Assistance Program Application
FORMS: CFDA#84.310A
OMB NO: 1855-0003 EXPIRATION DATE: 08/31/2003
RESPS:58 HOURS:226 COSTS(000):$0
Goals 2000, Parental Information and Resource Center's Annual/
Final Performance Report (JM)
FORMS: NONE
OMB NO: 1855-0004 EXPIRATION DATE: 05/31/2003
RESPS:200 HOURS:3,200 COSTS(000):$0
Arts in Education Competitive Grants Program
FORMS: CFDA-84.926B
OMB NO: 1855-0005 EXPIRATION DATE: 05/31/2004
RESPS:200 HOURS:6,000 COSTS(000):$0
Applications for Grants Under the Dropout Prevention
Demonstration Program
FORMS: NONE
OMB NO: 1855-0006 EXPIRATION DATE: 05/31/2004
RESPS:60 HOURS:3,600 COSTS(000):$0
Applications for Grants Under the Arts in Education
Demonstration and Dissemination Grant Program
FORMS: NONE
OMB NO: 1855-0007 EXPIRATION DATE: 02/28/2006
RESPS:30 HOURS:2,400 COSTS(000):$0
Credit Enhancement for Charter School Facilities Program
FORMS: NONE
OMB NO: 1855-0008 EXPIRATION DATE: 05/31/2003
RESPS:211 HOURS:2,975 COSTS(000):$0
Technology Innovation Challenge Grant Program Online Annual
FORMS: CFDA-84.303A
OMB NO: 1855-0009 EXPIRATION DATE: 05/31/2003
RESPS:23 HOURS:3,260 COSTS(000):$0
Star Schools Program Online Annual Performance Reporting System
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
9 1,012 30,381 $0
Office of Intergovernmental and Interagency Affairs
OMB NO: 1860-0504 EXPIRATION DATE: 11/30/2004
RESPS:2,600 HOURS:41,600 COSTS(000):$0
Applications for the U.S. Presidential Scholars Program
FORMS: NONE
OMB NO: 1860-0505 EXPIRATION DATE: 10/31/2004
RESPS:720 HOURS:60 COSTS(000):$0
Sign-on form for Partnership for Family Involvement in Education
FORMS: NONE
OMB NO: 1860-0506 EXPIRATION DATE: 11/30/2005
RESPS:420 HOURS:16,800 COSTS(000):$0
No Child Left Behind--Blue Ribbon Schools Program
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
3 3,740 58,460 $0
Office of Safe and Drug Free Schools
OMB NO: 1865-0001 EXPIRATION DATE: 11/30/2003
RESPS:400 HOURS:9,500 COSTS(000):$0
Safe and Drug-Free Schools and Communities National
Programs--Federal Activities Discretionary Grant Program
FORMS: CFDA#84.184K 84.184M
OMB NO: 1865-0002 EXPIRATION DATE: 08/31/2003
RESPS:12,672 HOURS:27,042 COSTS(000):$0
Gun-Free Schools Act Report (KA)
FORMS: NONE
OMB NO: 1865-0003 EXPIRATION DATE: 07/31/2003
RESPS:75 HOURS:1,650 COSTS(000):$0
Safe and Drug-Free Schools and Communities National Programs--
Federal Activities--Grant Competition to Prevent High-Risk
Drinking and Violent Behavior Among College Students
FORMS: 84.184H
OMB NO: 1865-0004 EXPIRATION DATE: 05/31/2004
RESPS:450 HOURS:13,500 COSTS(000):$0
Safe Schools/Healthy Students Intiative
FORMS: CFDA-84.184L
OMB NO: 1865-0006 EXPIRATION DATE: 01/31/2006
RESPS:50,000 HOURS:30,000 COSTS(000):$0
National College Alcohol, Drug and Violence Survey
FORMS: NONE
OMB NO: 1865-0008 EXPIRATION DATE: 04/30/2003
RESPS:400 HOURS:11,200 COSTS(000):$0
Elementary School Counseling Demonstration Program
FORMS: NONE
OMB NO: 1865-0009 EXPIRATION DATE: 09/30/2003
RESPS:56 HOURS:2,240 COSTS(000):$0
Safe and Drug-Free Schools and Communities Act of the Governor's
Report Forms
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
7 64,053 95,132 $0
Office for Civil Rights
OMB NO: 1870-0500 EXPIRATION DATE: 12/31/2003
RESPS:33,000 HOURS:337,500 COSTS(000):$0
2002 Elementary and Secondary School Survey (also referred to as
the Elementary and Secondary School Civil Rights Compliance
Report)
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
1 33,000 337,500 $0
Office of the Under Secretary
OMB NO: 1875-0106 EXPIRATION DATE: 11/30/2004
RESPS:17,000 HOURS:4,250 COSTS(000):$0
Application for Federal Education Assistance (AFEA)
FORMS: NONE
OMB NO: 1875-0154 EXPIRATION DATE: 12/31/2004
RESPS:1 HOURS:3,098 COSTS(000):$0
National Evaluation of Upward Bound and Upward Bound Math Science
FORMS: NONE
OMB NO: 1875-0177 EXPIRATION DATE: 05/31/2003
RESPS:350,427 HOURS:56,423 COSTS(000):$16
21st Century Community Learning Centers Annual Performance Report
FORMS: NONE
OMB NO: 1875-0180 EXPIRATION DATE: 07/31/2003
RESPS:185 HOURS:6,474 COSTS(000):$0
Annual Performance Reporting for the Gaining Early Awareness
FORMS: CFDA#:84.334
OMB NO: 1875-0182 EXPIRATION DATE: 08/31/2003
RESPS:800 HOURS:800 COSTS(000):$0
Class-Size Reduction Program
FORMS: NONE
OMB NO: 1875-0183 EXPIRATION DATE: 11/30/2003
RESPS:26,325 HOURS:42,090 COSTS(000):$0
Evaluation of the 21st Century Community Learning Centers Program
FORMS: NONE
OMB NO: 1875-0185 EXPIRATION DATE: 09/30/2003
RESPS:303 HOURS:1,515 COSTS(000):$0
Annual Performance Report for the Preparing Tomorrow's Teachers
FORMS: NONE
OMB NO: 1875-0186 EXPIRATION DATE: 10/31/2003
RESPS:1 HOURS:7,916 COSTS(000):$0
Moving Standards to the Classroom: A Study of Standard-Based
Mathematics Instruction in Six States
FORMS: NONE
OMB NO: 1875-0190 EXPIRATION DATE: 10/31/2003
RESPS:77 HOURS:3,161 COSTS(000):$0
Teacher Quality Enhancement Grants Program Annual Performance
FORMS: NONE
OMB NO: 1875-0191 EXPIRATION DATE: 10/31/2003
RESPS:11,565 HOURS:5,210 COSTS(000):$0
The National Evaluation of GEAR UP
FORMS: NONE
OMB NO: 1875-0193 EXPIRATION DATE: 02/29/2004
RESPS:3,000 HOURS:1,500 COSTS(000):$0
Study to Assess the Quality of Vocational Education in the
United States
FORMS: NONE
OMB NO: 1875-0194 EXPIRATION DATE: 11/30/2003
RESPS:873 HOURS:2,055 COSTS(000):$99
Assessing Literacy Models in the Boston Public Schools (JM)
FORMS: NONE
OMB NO: 1875-0195 EXPIRATION DATE: 01/31/2004
RESPS:1 HOURS:15,408 COSTS(000):$0
Redesignation of Students Served by Title VII Projects
(1890-0001) (JM)
FORMS: NONE
OMB NO: 1875-0196 EXPIRATION DATE: 03/31/2004
RESPS:1,298 HOURS:1,044 COSTS(000):$0
Evaluation of the Federal Class Size Reduction Program (JM)
FORMS: NONE
OMB NO: 1875-0199 EXPIRATION DATE: 05/31/2005
RESPS:1,275 HOURS:2,513 COSTS(000):$0
Evaluation of the Partnership Grants Program, Title II, Higher
Education Act Revision of Collection
FORMS: NONE
OMB NO: 1875-0201 EXPIRATION DATE: 05/31/2004
RESPS:2,200 HOURS:1,000 COSTS(000):$0
Evaluation of the State Grants Program and Teacher Recruitment
FORMS: NONE
OMB NO: 1875-0203 EXPIRATION DATE: 05/31/2004
RESPS:249 HOURS:9,520 COSTS(000):$0
GEPA Section 424 Data Collection on the Distribution of Federal
Education Funds (JM)
FORMS: NONE
OMB NO: 1875-0204 EXPIRATION DATE: 06/30/2004
RESPS:14,326 HOURS:13,753 COSTS(000):$0
Study of the SDFSCA Middle School Coordinator Initiative
FORMS: NONE
OMB NO: 1875-0205 EXPIRATION DATE: 01/31/2005
RESPS:6,384 HOURS:5,829 COSTS(000):$0
Evaluation of Title I Accountability Systems and School
Improvement Efforts (TASSIE)
FORMS: NONE
OMB NO: 1875-0207 EXPIRATION DATE: 08/31/2004
RESPS:2,000 HOURS:8,000 COSTS(000):$0
National Study of Title I Schools - Sampling Package
FORMS: NONE
OMB NO: 1875-0210 EXPIRATION DATE: 08/31/2004
RESPS:168 HOURS:144 COSTS(000):$0
State Vocational Directors Survey on Perkins III Funding and
Accountability Systems
FORMS: NONE
OMB NO: 1875-0212 EXPIRATION DATE: 10/31/2004
RESPS:106 HOURS:264 COSTS(000):$0
Study of State Administration of Even Start and Statewide Family
Literacy Initiative Grants
FORMS: NONE
OMB NO: 1875-0215 EXPIRATION DATE: 02/28/2005
RESPS:1,035 HOURS:735 COSTS(000):$0
The Reading Excellence Act School and Classroom Implementation
and Impact Study, Sampling Clearance Package
FORMS: NONE
OMB NO: 1875-0217 EXPIRATION DATE: 03/31/2005
RESPS:1,377 HOURS:3,123 COSTS(000):$282,745
The National Evaluation of Smaller Learning Communities (SC)
FORMS: NONE
OMB NO: 1875-0218 EXPIRATION DATE: 02/28/2005
RESPS:1,005 HOURS:488 COSTS(000):$0
Information Technology Skill Certification Study
FORMS: NONE
OMB NO: 1875-0219 EXPIRATION DATE: 04/30/2005
RESPS:2,897 HOURS:909 COSTS(000):$0
An Evaluation of the Rehabilitation Services Administration
(RSA) Training Programs' Responsiveness to State VR Agency Needs
for Qualified Personnel
FORMS: NONE
OMB NO: 1875-0221 EXPIRATION DATE: 07/31/2003
RESPS:220 HOURS:272 COSTS(000):$0
Study to Assess Funding, Accountability, and One-Stop Delivery
Systems in Adult Education
FORMS: NONE
OMB NO: 1875-0222 EXPIRATION DATE: 01/31/2006
RESPS:4,380 HOURS:2,567 COSTS(000):$0
Longitudinal Assessment of CSR Implementation and Outcomes
(LACIO)
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
28 449,478 200,061 $282,860
Office of English Language Acquisition
OMB NO: 1885-0513 EXPIRATION DATE: 08/31/2004
RESPS:1,313 HOURS:7,828 COSTS(000):$0
Biennial Report Form for the Emergency Immigrant Education
FORMS: ED-T85-IP
OMB NO: 1885-0531 EXPIRATION DATE: 11/30/2003
RESPS:300 HOURS:7,650 COSTS(000):$0
Application for Grants Under School Improvement: Elementary
School Foreign Language Incentive Program (SC)
FORMS: 84.294A
OMB NO: 1885-0540 EXPIRATION DATE: 01/31/2006
RESPS:250 HOURS:20,000 COSTS(000):$0
School Improvement: Foreign Language Assistance Program for
Local Educational Agencies (1890-0001)(SC)
FORMS: 84.293B
OMB NO: 1885-0544 EXPIRATION DATE: 01/31/2006
RESPS:50 HOURS:4,000 COSTS(000):$0
School Improvement Foreign Language Assistance Program for State
Educational Agencies (1890-0001)(SC)
FORMS: 84.293C
OMB NO: 1885-0550 EXPIRATION DATE: 04/30/2004
RESPS:300 HOURS:30,600 COSTS(000):$0
Application for Grants Under English Language Acquisition:
National Professional Development Program (1890-0001) (SC)
FORMS: NONE
OMB NO: 1885-0551 EXPIRATION DATE: 10/31/2005
RESPS:100 HOURS:8,200 COSTS(000):$0
Application for Grants Under English Language Acquisition and
Language Enhancement: Native American and Alaska Native Children
in School (SC)
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
6 2,313 78,278 $0
Office of the Chief Financial Officer
OMB NO: 1890-0001 EXPIRATION DATE: 03/31/2004
RESPS:1 HOURS:1 COSTS(000):$0
Streamlined Clearance Process for Discretionary Grant
FORMS: NONE
OMB NO: 1890-0004 EXPIRATION DATE: 04/30/2003
RESPS:23,248 HOURS:500,055 COSTS(000):$2
Grant Performance Report (JM)
FORMS: 524 524-B
OMB NO: 1890-0006 EXPIRATION DATE: 09/30/2004
RESPS:1 HOURS:1 COSTS(000):$0
Sreamlined Process for Education Department General
Administrative Regulations (EDGAR) Approved Grant Applications
FORMS: NONE
OMB NO: 1890-0007 EXPIRATION DATE: 09/30/2004
RESPS:21,200 HOURS:31,800 COSTS(000):$0
GEPA Section 427 Guidance for All Grant Applications (JM)
FORMS: NONE
OMB NO: 1890-0009 EXPIRATION DATE: 06/30/2005
RESPS:10,297 HOURS:244,906 COSTS(000):$0
Generic Application Package for Discretionary Grant Programs
FORMS: NONE
OMB NO: 1890-0012 EXPIRATION DATE: 02/28/2006
RESPS:250 HOURS:10,000 COSTS(000):$0
Small Business Innovation Research (SBIR) Program - Phase I -
Grant Application Package
FORMS: CFDA#-84.133S 84.305S 84.191S 84.051S 84.017S
OMB NO: 1890-0014 EXPIRATION DATE: 01/31/2006
RESPS:17,000 HOURS:1,360 COSTS(000):$0
Survey on Ensuring Equal Opportunity for Applicants
FORMS: NONE
OMB NO: 1890-0015 EXPIRATION DATE: 03/31/2006
RESPS:50 HOURS:3,750 COSTS(000):$0
Small Business Innovation Research (SBIR) Program - Phase II -
Grant Application Package
FORMS: 84.133S 84.305S 84.191S 84.051S 84.017S
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
8 72,047 791,873 $2
AGENCY TOTALS:
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
283 58,892,673 40,649,579 $538,444
Department of Energy
Departmental and Others
OMB NO: 1901-0260 EXPIRATION DATE: 07/31/2003
RESPS:468 HOURS:2,664 COSTS(000):$0
Standard Contract for Disposal of Spent Nuclear Fuel and/or
High- Level Radioactive Waste
FORMS: 830-G
OMB NO: 1901-0287 EXPIRATION DATE: 02/28/2005
RESPS:127 HOURS:1,237 COSTS(000):$0
Nuclear Fuel Data Form
FORMS: RW-859
OMB NO: 1901-0288 EXPIRATION DATE: 08/31/2005
RESPS:300 HOURS:7,310 COSTS(000):$0
Electric Emergency Incident and Disturbance Report
FORMS: 417
OMB NO: 1901-0294 EXPIRATION DATE: 03/31/2005
RESPS:1,370 HOURS:4,240 COSTS(000):$0
Import and Export of Natural Gas
FORMS: FE-746R
OMB NO: 1901-0296 EXPIRATION DATE: 02/29/2004
RESPS:540 HOURS:1,650 COSTS(000):$0
Report of International Electrical Export/Import Data
FORMS: FE-781R
OMB NO: 1901-0302 EXPIRATION DATE: 09/30/2003
RESPS:50,000 HOURS:12,500 COSTS(000):$0
DOE Customer Surveys
FORMS: 887
OMB NO: 1901-0303 EXPIRATION DATE: 07/31/2003
RESPS:40 HOURS:160 COSTS(000):$0
Annual Geothermal Heat Pump Manufacturers Survey
FORMS: 902
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
7 52,845 29,761 $0
Economic Regulatory Administration
OMB NO: 1903-0073 EXPIRATION DATE: 02/28/2006
RESPS:100 HOURS:400 COSTS(000):$0
Recordkeeping Requirements of DOE's General Allocation and Price
Rules
FORMS: 766R
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
1 100 400 $0
Energy Information Administration
OMB NO: 1905-0057 EXPIRATION DATE: 12/31/2003
RESPS:4,505 HOURS:74,236 COSTS(000):$0
Oil and Gas Reserves System Surveys
FORMS: 23 23P 64A
OMB NO: 1905-0092 EXPIRATION DATE: 02/29/2004
RESPS:5,127 HOURS:2,842 COSTS(000):$0
Residential Energy Consumption Survey (RECS)
FORMS: 457-A/G
OMB NO: 1905-0129 EXPIRATION DATE: 11/30/2004
RESPS:37,960 HOURS:173,990 COSTS(000):$0
Electric Power Surveys
FORMS: EIA-411 EIA-412 EIA-423 EIA-767 EIA-826 EIA-860 EIA-861 EIA-906
OMB NO: 1905-0149 EXPIRATION DATE: 11/30/2005
RESPS:30 HOURS:13,470 COSTS(000):$0
Financial Reporting System
FORMS: 28
OMB NO: 1905-0160 EXPIRATION DATE: 11/30/2003
RESPS:132 HOURS:2,424 COSTS(000):$0
Uranium Data Program
FORMS: 851 858
OMB NO: 1905-0165 EXPIRATION DATE: 01/31/2006
RESPS:47,117 HOURS:60,006 COSTS(000):$0
Petroleum Supply Reporting System
FORMS: EIA-800-804 807 810-814 816 817 819M 820
OMB NO: 1905-0167 EXPIRATION DATE: 03/31/2005
RESPS:5,201 HOURS:9,246 COSTS(000):$0
Coal Program Package
FORMS: EIA-1 3 4 5 6A 6Q 7A 20
OMB NO: 1905-0169 EXPIRATION DATE: 03/31/2006
RESPS:6,000 HOURS:55,291 COSTS(000):$0
Manufacturing Energy Consumption Survey (MECS)
FORMS: 846(A) 846(B) 846(C)
OMB NO: 1905-0174 EXPIRATION DATE: 11/30/2003
RESPS:134,594 HOURS:125,513 COSTS(000):$0
Petroleum Marketing Program
FORMS: 14 182 782A/B/C 821 856 863 877 878 888
OMB NO: 1905-0175 EXPIRATION DATE: 11/30/2005
RESPS:12,564 HOURS:45,464 COSTS(000):$0
Natural Gas Data Collection Program Package
FORMS: 176 191 857 895 910 912
OMB NO: 1905-0186 EXPIRATION DATE: 08/31/2005
RESPS:4,000 HOURS:1,000 COSTS(000):$0
Generic Clearance of Questionnaire Testing, Evaluation, and
Research
FORMS: 882-T
OMB NO: 1905-0191 EXPIRATION DATE: 05/31/2004
RESPS:2,491 HOURS:10,323 COSTS(000):$0
Annual Survey of Alternative Fueled Vehicle Suppliers and Users
FORMS: EIA-886
OMB NO: 1905-0194 EXPIRATION DATE: 10/31/2003
RESPS:220 HOURS:7,000 COSTS(000):$0
Voluntary Reporting of Greenhouse Gases
FORMS: EIA-1605 EIA-1605EZ
OMB NO: 1905-0196 EXPIRATION DATE: 09/30/2004
RESPS:110 HOURS:330 COSTS(000):$0
Annual Solar Thermal Collector Manufacturers Survey and Annual
Photovoltaic Module/Cell Manufacturers Survey
FORMS: EIA-63A EIA-63B
OMB NO: 1905-0202 EXPIRATION DATE: 05/31/2004
RESPS:2,112 HOURS:6,572 COSTS(000):$0
Monthly Natural Gas Marketers Survey
FORMS: EIA-910
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
15 262,163 587,707 $0
Office of Administration
OMB NO: 1910-0068 EXPIRATION DATE: 10/31/2004
RESPS:75 HOURS:450 COSTS(000):$0
Renewable Energy Production Incentive
FORMS: NONE
OMB NO: 1910-0100 EXPIRATION DATE: 04/30/2005
RESPS:438 HOURS:6,814 COSTS(000):$0
Information Management
FORMS: NONE
OMB NO: 1910-0300 EXPIRATION DATE: 03/31/2006
RESPS:11,344 HOURS:269,475 COSTS(000):$0
Environment Safety and Health
FORMS: NONE
OMB NO: 1910-0400 EXPIRATION DATE: 12/31/2005
RESPS:44,457 HOURS:415,544 COSTS(000):$0
Financial Assistance
FORMS: NONE
OMB NO: 1910-0500 EXPIRATION DATE: 04/30/2003
RESPS:12,715 HOURS:164,528 COSTS(000):$0
Financial Management
FORMS: NONE
OMB NO: 1910-0600 EXPIRATION DATE: 03/31/2005
RESPS:575 HOURS:10,421 COSTS(000):$0
Industrial Relations
FORMS: NONE
OMB NO: 1910-0800 EXPIRATION DATE: 03/31/2005
RESPS:1 HOURS:14,100 COSTS(000):$0
Legal Collections Package
FORMS: NONE
OMB NO: 1910-1000 EXPIRATION DATE: 04/30/2003
RESPS:3,857 HOURS:247,374 COSTS(000):$0
Personal Property
FORMS: NONE
OMB NO: 1910-1400 EXPIRATION DATE: 02/29/2004
RESPS:99 HOURS:1,584 COSTS(000):$0
Compliance Statement: Energy/Water Conservation Standards for
Appliances
FORMS: NONE
OMB NO: 1910-1800 EXPIRATION DATE: 04/30/2003
RESPS:86,596 HOURS:612,985 COSTS(000):$0
Safe Guards and Security
FORMS: NONE
OMB NO: 1910-4100 EXPIRATION DATE: 02/28/2005
RESPS:3,811 HOURS:1,086,529 COSTS(000):$0
Procurement (see attached chart for the collection requirements).
FORMS: NONE
OMB NO: 1910-5101 EXPIRATION DATE: 03/31/2006
RESPS:310 HOURS:1,550 COSTS(000):$0
U.S Dept. of Energy: Annual Alternative Fuel Vehical Acquisition
Report for State Government & Alternative Fuel Provider Fleets
FORMS: DOE\FCVT\101
OMB NO: 1910-5102 EXPIRATION DATE: 03/31/2006
RESPS:36 HOURS:5,350 COSTS(000):$0
Make or Buy Plans
FORMS: NONE
OMB NO: 1910-5104 EXPIRATION DATE: 08/31/2004
RESPS:41 HOURS:12,300 COSTS(000):$452
10 CFR 431 -- Energy Efficiency Program for Certain Commercial
and Industrial Equipment: Test Procedures, Labeling, and
Certification Requirements for Electric Motors
FORMS: NONE
OMB NO: 1910-5105 EXPIRATION DATE: 08/31/2004
RESPS:50 HOURS:50,000 COSTS(000):$0
Occupational Radiation Protection Program
FORMS: NONE
OMB NO: 1910-5111 EXPIRATION DATE: 04/30/2003
RESPS:20 HOURS:100 COSTS(000):$0
Disclosure of Relevant Interests by Firms That Are Members of
Apparent Successful Offeror Joint Venture of Other Formal
Teaming Arrangement
FORMS: NONE
OMB NO: 1910-5112 EXPIRATION DATE: 04/30/2003
RESPS:30,861 HOURS:54,762 COSTS(000):$2,088
Chronic Beryllium Disease Prevention Program
FORMS: NONE
OMB NO: 1910-5115 EXPIRATION DATE: 04/30/2004
RESPS:36 HOURS:515 COSTS(000):$0
Contractor Legal Management Requirements
FORMS: NONE
OMB NO: 1910-5117 EXPIRATION DATE: 03/31/2005
RESPS:124 HOURS:31,000 COSTS(000):$1,364
10 CFR Part 431 - Certification Requirements for Commercial
Heating and Air Conditioning Equipment
FORMS: NONE
OMB NO: 1910-5118 EXPIRATION DATE: 06/30/2005
RESPS:96 HOURS:100 COSTS(000):$0
Technology Partnerships Ombudsmen Reporting Requirements
FORMS: NONE
OMB NO: 1910-5120 EXPIRATION DATE: 08/31/2005
RESPS:8,000 HOURS:8,000 COSTS(000):$0
Physicians Panel Guidelines
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
21 203,542 2,993,481 $3,904
AGENCY TOTALS:
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
44 518,650 3,611,349 $3,904
Department of Health and Human Services
Food and Drug Administration
OMB NO: 0910-0001 EXPIRATION DATE: 03/31/2005
RESPS:20,360 HOURS:1,984,003 COSTS(000):$0
Applications for FDA Approval to Market a New Drug -- Part 314
FORMS: NONE
OMB NO: 0910-0012 EXPIRATION DATE: 04/30/2003
RESPS:6,750 HOURS:54,225 COSTS(000):$0
Veterinary Adverse Drug Reaction, Lack of Effectiveness, Product
Defect Report, and Transmittal of Periodic Reports and
Promotional Material for New Animal Drugs. 21 CFR Part 510
FORMS: FDA-1932 FDA-1932A FDA-2301
OMB NO: 0910-0014 EXPIRATION DATE: 01/31/2006
RESPS:541,986 HOURS:36,040,829 COSTS(000):$0
Investigational New Drug (IND) Regulations
FORMS: FDA-1571 FDA-1572
OMB NO: 0910-0016 EXPIRATION DATE: 10/31/2003
RESPS:13 HOURS:69,320 COSTS(000):$0
Food Additive Petitions
FORMS: NONE
OMB NO: 0910-0021 EXPIRATION DATE: 07/31/2003
RESPS:58 HOURS:204 COSTS(000):$0
Interstate Shellfish Dealer's Certificate
FORMS: FDA-3038
OMB NO: 0910-0025 EXPIRATION DATE: 11/30/2003
RESPS:47,343 HOURS:324,957 COSTS(000):$0
Reporting and Recordkeeping Requirements and Availability of
Sample Electronic Products for Manufacturers and Distributors of
Electronic
FORMS: FDA-2579 FDA-2767 FDA-2877 FDA-3147
OMB NO: 0910-0027 EXPIRATION DATE: 08/31/2004
RESPS:1 HOURS:20 COSTS(000):$0
Voluntary Registration of Cosmetics Product Establishment
FORMS: FDA-2511
OMB NO: 0910-0030 EXPIRATION DATE: 11/30/2005
RESPS:2,015 HOURS:987 COSTS(000):$0
Cosmetic Product Voluntary Reporting Program - 21 CFR Part 720
FORMS: FDA-2512 2512A 2514
OMB NO: 0910-0032 EXPIRATION DATE: 07/31/2004
RESPS:1,582 HOURS:383,793 COSTS(000):$0
New Animal Drug Application, 21 CFR Part 514
FORMS: FDA-356V
OMB NO: 0910-0037 EXPIRATION DATE: 08/31/2005
RESPS:8,050 HOURS:1,502,828 COSTS(000):$0
Food Canning Establishment Registration Process Filing and
Recordkeeping for Acidified Foods and Thermally Processed
Low-Acid Foods in hermetically Sealed Containers
FORMS: 2541 2541A 2541C
OMB NO: 0910-0045 EXPIRATION DATE: 07/31/2004
RESPS:66,223 HOURS:33,112 COSTS(000):$0
Registration of Producers of Drugs and Lisitng of Drugs in
Commercial Distribution
FORMS: 2656 2656E 2657 2658
OMB NO: 0910-0046 EXPIRATION DATE: 08/31/2003
RESPS:2,533,355 HOURS:354,714 COSTS(000):$0
Electronic Importer's Entry Notice
FORMS: NONE
OMB NO: 0910-0052 EXPIRATION DATE: 02/28/2006
RESPS:3,167 HOURS:1,753 COSTS(000):$0
Blood Establishment Registration and Product Listing Form FDA
2830
FORMS: FDA-2830
OMB NO: 0910-0053 EXPIRATION DATE: 10/31/2004
RESPS:411 HOURS:2,910 COSTS(000):$0
Radioactive Drug Research Committee (RDRC) Report on Research
Use of Radioactive Drug Study Summary
FORMS: FDA-2914 FDA-2915
OMB NO: 0910-0073 EXPIRATION DATE: 07/31/2004
RESPS:1 HOURS:3,167,670 COSTS(000):$1,182
Medical Devices: Current Good Manufacturing Practice (CGMP),
Quality System (Q/S) Regulation; 21 CFR Part 820
FORMS: NONE
OMB NO: 0910-0078 EXPIRATION DATE: 08/31/2003
RESPS:4,527 HOURS:61,021 COSTS(000):$0
Investigational Device Exemptions Reports and Records - 21 CFR
812
FORMS: NONE
OMB NO: 0910-0114 EXPIRATION DATE: 08/31/2003
RESPS:26 HOURS:461 COSTS(000):$0
Administrative Detention and Banned Medical Devices
FORMS: NONE
OMB NO: 0910-0116 EXPIRATION DATE: 11/30/2005
RESPS:42,435 HOURS:335,346 COSTS(000):$0
Current Good Manufacturing Practices and Related Regulations for
Blood and Blood Components; and "Lookback" Requirements
FORMS: NONE
OMB NO: 0910-0117 EXPIRATION DATE: 03/31/2005
RESPS:21,510 HOURS:68,245 COSTS(000):$0
New Animal Drugs for Investigational Use - 21 CFR Part 511
FORMS: 3458
OMB NO: 0910-0119 EXPIRATION DATE: 09/30/2004
RESPS:36,150 HOURS:1,311,157 COSTS(000):$0
Good Laboratory Practice (GLP) Regulations for Nonclinical
Laboratory Studies - 21 CFR Part 58
FORMS: NONE
OMB NO: 0910-0120 EXPIRATION DATE: 09/30/2004
RESPS:4,000 HOURS:331,000 COSTS(000):$0
Premarket Notification 510(K) Submissions
FORMS: FDA-3514
OMB NO: 0910-0129 EXPIRATION DATE: 05/31/2003
RESPS:3 HOURS:330 COSTS(000):$0
Applications for Exemption From Federal Preemption of State and
Local Medical Device Requirements-21 CFR Part 808
FORMS: NONE
OMB NO: 0910-0130 EXPIRATION DATE: 09/30/2004
RESPS:29,200 HOURS:131,400 COSTS(000):$0
Protection of Human Subjects; Recordkeeping and Reporting
Requirements for Institutional Review Boards (IRB's)
FORMS: NONE
OMB NO: 0910-0131 EXPIRATION DATE: 11/30/2003
RESPS:1,800 HOURS:7,200 COSTS(000):$0
Agreement for Shipments of Devices for Sterilization
FORMS: NONE
OMB NO: 0910-0132 EXPIRATION DATE: 11/30/2003
RESPS:1 HOURS:2,614 COSTS(000):$0
Affirmation of Generally Recognized as Safe GRAS Status
FORMS: NONE
OMB NO: 0910-0133 EXPIRATION DATE: 07/31/2005
RESPS:11 HOURS:191 COSTS(000):$0
Temporary Marketing Permit Applications
FORMS: NONE
OMB NO: 0910-0138 EXPIRATION DATE: 01/31/2006
RESPS:6 HOURS:3,000 COSTS(000):$0
Reclassification Petitions for Medical Devices
FORMS: FDA-3427 3428 3429
OMB NO: 0910-0139 EXPIRATION DATE: 08/31/2005
RESPS:4,184 HOURS:848,625 COSTS(000):$0
Current Good Manufacturing Practice; Proposed Amendment of
Certain Requirements for Finished Pharmaceuticals
FORMS: NONE
OMB NO: 0910-0152 EXPIRATION DATE: 09/30/2004
RESPS:36,444,150 HOURS:7,317,151 COSTS(000):$0
Current Good Manufacturing Practice for Medicated Feed, 21 CFR
Part 225
FORMS: NONE
OMB NO: 0910-0154 EXPIRATION DATE: 09/30/2004
RESPS:180,550 HOURS:187,450 COSTS(000):$0
Good Manufacturing Practice for Type A Medicated Articles, 21
CFR Part 226
FORMS: NONE
OMB NO: 0910-0167 EXPIRATION DATE: 07/31/2004
RESPS:1 HOURS:20,964 COSTS(000):$0
Orphan Drug Products
FORMS: NONE
OMB NO: 0910-0182 EXPIRATION DATE: 04/30/2004
RESPS:23,070,000 HOURS:19,225 COSTS(000):$0
Use of Impact Resistant Lenses in Eyeglasses and Sunglasses OMB
No. 0910-0182
FORMS: NONE
OMB NO: 0910-0183 EXPIRATION DATE: 03/31/2006
RESPS:476 HOURS:5,678 COSTS(000):$0
General Administrative Procedures: Citizen Petitions; Petition
for Reconsideration or Stay of Action; Advisory Opinions
FORMS: NONE
OMB NO: 0910-0184 EXPIRATION DATE: 02/28/2006
RESPS:10 HOURS:200 COSTS(000):$0
Filing Objections and Requests for a Hearing on a Regulation or
Order
FORMS: NONE
OMB NO: 0910-0185 EXPIRATION DATE: 07/31/2005
RESPS:3 HOURS:6,000 COSTS(000):$9
Labeling Requirements for Color Additives (other than hair dyes)
and Petitions
FORMS: NONE
OMB NO: 0910-0186 EXPIRATION DATE: 04/30/2003
RESPS:360 HOURS:360 COSTS(000):$0
Irradiation in the Production, Processing and Handling of Food
FORMS: NONE
OMB NO: 0910-0188 EXPIRATION DATE: 07/31/2005
RESPS:3 HOURS:18,956 COSTS(000):$0
Infant Formula Recall Regulations - 21 CFR Part 107
FORMS: NONE
OMB NO: 0910-0191 EXPIRATION DATE: 04/30/2006
RESPS:1 HOURS:1,020 COSTS(000):$0
Notice of Participation
FORMS: NONE
OMB NO: 0910-0192 EXPIRATION DATE: 03/31/2004
RESPS:12 HOURS:120 COSTS(000):$0
Petition for Administrative Reconsideration of Action - 21 CFR
10.33
FORMS: NONE
OMB NO: 0910-0194 EXPIRATION DATE: 03/31/2004
RESPS:13 HOURS:130 COSTS(000):$0
Petition for Administrative Stay of Action - 21 CFR 10.35
FORMS: NONE
OMB NO: 0910-0206 EXPIRATION DATE: 08/31/2003
RESPS:7,221 HOURS:21,878 COSTS(000):$0
Request for Samples and Protocols
FORMS: NONE
OMB NO: 0910-0212 EXPIRATION DATE: 09/30/2005
RESPS:1,632 HOURS:2,424 COSTS(000):$0
Regulations Under the Federal Import Milk Act (21 CFR Part 1210)
(formerly Federal Import Milk Act)
FORMS: FDA-1815 1993 1994 1995 1996 1997
OMB NO: 0910-0216 EXPIRATION DATE: 08/31/2004
RESPS:4,346 HOURS:2,172 COSTS(000):$0
Color Additive Certification Requests and Recordkeeping
FORMS: NONE
OMB NO: 0910-0230 EXPIRATION DATE: 09/30/2005
RESPS:10,959 HOURS:287,574 COSTS(000):$1,416
Postmarketing Adverse Drug Experienced Reporting - 21 CFR
310.305 and 314.80
FORMS: FDA-3500 FDA-3500A
OMB NO: 0910-0231 EXPIRATION DATE: 08/31/2004
RESPS:487 HOURS:107,321 COSTS(000):$0
Premarket Approval of Medical Devices; 21 CFR Part 814
FORMS: NONE
OMB NO: 0910-0233 EXPIRATION DATE: 09/30/2004
RESPS:1 HOURS:100 COSTS(000):$0
Patent Term Restoration, due Diligence Petitions, Filing,
Format, and Content of Petitions
FORMS: NONE
OMB NO: 0910-0249 EXPIRATION DATE: 10/31/2004
RESPS:12,985 HOURS:157,675 COSTS(000):$0
FDA Recall Regulations
FORMS: NONE
OMB NO: 0910-0256 EXPIRATION DATE: 02/29/2004
RESPS:40 HOURS:25,560 COSTS(000):$0
Infant Formula Requirements
FORMS: NONE
OMB NO: 0910-0264 EXPIRATION DATE: 11/30/2003
RESPS:20 HOURS:50 COSTS(000):$0
Export of Medical Devices - Foreign Letters of Approval
FORMS: NONE
OMB NO: 0910-0275 EXPIRATION DATE: 10/31/2005
RESPS:1 HOURS:10 COSTS(000):$0
State Enforcement Notifications (21 CFR 100.2(d))
FORMS: NONE
OMB NO: 0910-0277 EXPIRATION DATE: 07/31/2005
RESPS:1 HOURS:40 COSTS(000):$0
State Petitions for Exemption from Preemption
FORMS: NONE
OMB NO: 0910-0279 EXPIRATION DATE: 06/30/2004
RESPS:1 HOURS:609 COSTS(000):$0
Year 2001 Updates of a National Survey of Prescription Drug
Informaion Provided to Patients
FORMS: NONE
OMB NO: 0910-0291 EXPIRATION DATE: 04/30/2003
RESPS:332,414 HOURS:332,414 COSTS(000):$0
MedWatch: The FDA Medical Products Reporting Program
FORMS: FDA-3500 3500A
OMB NO: 0910-0297 EXPIRATION DATE: 02/29/2004
RESPS:2,921 HOURS:876 COSTS(000):$0
User Fee Cover Sheet
FORMS: FDA-3397
OMB NO: 0910-0298 EXPIRATION DATE: 02/29/2004
RESPS:6 HOURS:288 COSTS(000):$0
Food additives; Threshold of Regulation for Substances Used in
Food-Contact Articles
FORMS: NONE
OMB NO: 0910-0302 EXPIRATION DATE: 03/31/2004
RESPS:56 HOURS:382,388 COSTS(000):$0
Human Tissue Intended for Transplantation
FORMS: NONE
OMB NO: 0910-0303 EXPIRATION DATE: 05/31/2003
RESPS:4,500 HOURS:270,000 COSTS(000):$0
Electronic Records: Electronic Signatures
FORMS: NONE
OMB NO: 0910-0308 EXPIRATION DATE: 04/30/2003
RESPS:17,406 HOURS:268,803 COSTS(000):$0
Adverse Experience Reporting for Licensed Biological Products;
and General Records
FORMS: N/A
OMB NO: 0910-0309 EXPIRATION DATE: 02/29/2004
RESPS:39,996,722 HOURS:3,516,183 COSTS(000):$21
Mammography Facilities, Standards, and Lay Summaries For Patients
FORMS: FDA-3422
OMB NO: 0910-0320 EXPIRATION DATE: 08/31/2004
RESPS:206 HOURS:555 COSTS(000):$0
Request for Information from U.S. Processors that Export to the
European Community
FORMS: NONE
OMB NO: 0910-0322 EXPIRATION DATE: 08/31/2003
RESPS:10,941 HOURS:230,040 COSTS(000):$0
21 CFR 25 - Environmental Impact Considerations
FORMS: NONE
OMB NO: 0910-0325 EXPIRATION DATE: 09/30/2005
RESPS:2 HOURS:8,320 COSTS(000):$0
Extra Label Drug Use in Animals
FORMS: NONE
OMB NO: 0910-0330 EXPIRATION DATE: 07/31/2005
RESPS:35 HOURS:700 COSTS(000):$0
Premarket Notification for a New Dietary Ingredient
FORMS: NONE
OMB NO: 0910-0331 EXPIRATION DATE: 12/31/2003
RESPS:2,500 HOURS:1,875 COSTS(000):$0
Food Labeling; Notification Procedures for Statement on Dietary
Supplements
FORMS: NONE
OMB NO: 0910-0332 EXPIRATION DATE: 11/30/2005
RESPS:129 HOURS:11,398 COSTS(000):$0
Medical Devices; Humanitarian Use Devices; 21 CFR Part 814 -
Subpart H
FORMS: NONE
OMB NO: 0910-0337 EXPIRATION DATE: 11/30/2003
RESPS:175 HOURS:72 COSTS(000):$0
Medicated Feed Mill License Application
FORMS: FDA-3448
OMB NO: 0910-0338 EXPIRATION DATE: 08/31/2005
RESPS:5,715 HOURS:301,752 COSTS(000):$349
General Licensing Provisions: Biologics License Application,
Changes to an Approved Application, Labeling; and Revocation and
Suspension
FORMS: FDA-2567 FDA-356H
OMB NO: 0910-0339 EXPIRATION DATE: 02/29/2004
RESPS:1 HOURS:14,420 COSTS(000):$0
Substances Prohibited from use in Animal Food or Feed; Animal
Proteins Prohibited in Ruminant Feed, 21 CFR 589.2000
FORMS: NONE
OMB NO: 0910-0340 EXPIRATION DATE: 04/30/2005
RESPS:39,910 HOURS:120,525 COSTS(000):$0
Over-the-Counter Human Drugs; Labeling Requirements
FORMS: NONE
OMB NO: 0910-0341 EXPIRATION DATE: 05/31/2003
RESPS:924 HOURS:157 COSTS(000):$0
FDA Safety Alert/Public Health Advisory Readership Survey
FORMS: NONE
OMB NO: 0910-0342 EXPIRATION DATE: 05/31/2003
RESPS:60 HOURS:9,900 COSTS(000):$0
Notice of a Claim for GRAS exemption based on a GRAS
Determination
FORMS: NONE
OMB NO: 0910-0345 EXPIRATION DATE: 02/29/2004
RESPS:2,000 HOURS:1,000 COSTS(000):$0
Food Safety Survey
FORMS: NONE
OMB NO: 0910-0352 EXPIRATION DATE: 11/30/2003
RESPS:45 HOURS:4,320 COSTS(000):$0
Latex Condoms; User Labeling - Expiration Dating (21 CFR 801.435)
FORMS: NONE
OMB NO: 0910-0353 EXPIRATION DATE: 03/31/2004
RESPS:18 HOURS:1,178 COSTS(000):$0
Sterility Requirement for Aqueous-Based Drug Products for Oral
Inhalation; final rule
FORMS: NONE
OMB NO: 0910-0354 EXPIRATION DATE: 02/29/2004
RESPS:5,850 HOURS:627,075 COSTS(000):$0
Procedures for the Safe Processing and Importing of Fish and
Fishery Products; 21 CFR Part 123
FORMS: NONE
OMB NO: 0910-0356 EXPIRATION DATE: 02/29/2004
RESPS:860 HOURS:544,036 COSTS(000):$0
Substantial Evidence of Effectiveness of New Animal Drugs
FORMS: NONE
OMB NO: 0910-0359 EXPIRATION DATE: 03/31/2005
RESPS:880 HOURS:13,200 COSTS(000):$0
Reports of corrections and Removals; 21 CFR Part 806
FORMS: NONE
OMB NO: 0910-0360 EXPIRATION DATE: 03/31/2005
RESPS:20,000 HOURS:6,000 COSTS(000):$0
Customer/Partner Service Surveys - (Extension)
FORMS: NONE
OMB NO: 0910-0361 EXPIRATION DATE: 03/31/2004
RESPS:300 HOURS:15,000 COSTS(000):$0
Classification/reclassification; Restricted Devices; Analyte
Specific Reagents
FORMS: N/A
OMB NO: 0910-0363 EXPIRATION DATE: 10/31/2005
RESPS:1,880,521 HOURS:120,184 COSTS(000):$0
Veterinary Feed Directive (VFD) 21 CFR Part 558
FORMS: NONE
OMB NO: 0910-0364 EXPIRATION DATE: 04/30/2004
RESPS:30 HOURS:30 COSTS(000):$15
Nutrition Labeline: Declaration of Caloric Amounts and Serving
Sizes for Breath Mints
FORMS: NONE
OMB NO: 0910-0368 EXPIRATION DATE: 03/31/2004
RESPS:20 HOURS:2,000 COSTS(000):$0
OTC Test Sample Collection Systems for Drugs of Abuse Testing -
21 CFR Part 809
FORMS: NONE
OMB NO: 0910-0370 EXPIRATION DATE: 07/31/2004
RESPS:588 HOURS:1,920 COSTS(000):$0
Specific Requirements on Content and Format of Labeling;
Geriatric Use Subsection
FORMS: NONE
OMB NO: 0910-0374 EXPIRATION DATE: 08/31/2005
RESPS:3 HOURS:1,153 COSTS(000):$0
Guidance for Industry: Notification of a Health Claim or
Nutrient Content Claim Based on an Authoritative Statement of a
Scientific Body
FORMS: NONE
OMB NO: 0910-0375 EXPIRATION DATE: 10/31/2004
RESPS:140 HOURS:7,960 COSTS(000):$0
Medical Devices; Third Party Review Under FDAMA
FORMS: NONE
OMB NO: 0910-0376 EXPIRATION DATE: 10/31/2004
RESPS:16,640 HOURS:33,280 COSTS(000):$0
Transmittal of Advertising and Promotional Labeling for Drugs
and Biologics for Human Use
FORMS: FDA-2253
OMB NO: 0910-0378 EXPIRATION DATE: 03/31/2005
RESPS:220 HOURS:5,760 COSTS(000):$0
Medical Devices; Third-Party Premarket Submission Review and
Quality System Inspections Under U.S./E.C. Mutual Recognition
Agreement
FORMS: NONE
OMB NO: 0910-0381 EXPIRATION DATE: 02/29/2004
RESPS:509,579 HOURS:1,594,269 COSTS(000):$16,800
Food Labeling Regulations
FORMS: NONE
OMB NO: 0910-0387 EXPIRATION DATE: 03/31/2005
RESPS:1 HOURS:66,461 COSTS(000):$0
Medical Device Registration and Listing: 21 CFR Parts 807.22 and
807.31
FORMS: 2891 2891A 2782
OMB NO: 0910-0389 EXPIRATION DATE: 06/30/2005
RESPS:86 HOURS:6,480 COSTS(000):$0
Guidance for Industry: Fast Track Drug Development Programs -
Designation, Development & Application Review
FORMS: NONE
OMB NO: 0910-0390 EXPIRATION DATE: 11/30/2005
RESPS:4,492 HOURS:52,208 COSTS(000):$0
Dissemination of Information on Unapproved/New Uses for Marketed
Drugs, Biologics, and Devices
FORMS: NONE
OMB NO: 0910-0392 EXPIRATION DATE: 10/31/2005
RESPS:64 HOURS:18,557 COSTS(000):$80,000
Regulations Requiring Manufacturers to Assess the Safety and
Effectiveness of New Drugs and Biological Products in Pediatric
Patients
FORMS: NONE
OMB NO: 0910-0393 EXPIRATION DATE: 03/31/2005
RESPS:460,012 HOURS:2,651 COSTS(000):$0
Prescription Drug Product Labeling - Medication Guide Requirement
FORMS: NONE
OMB NO: 0910-0395 EXPIRATION DATE: 01/31/2005
RESPS:850 HOURS:213 COSTS(000):$83
Food Labeling: Nutrition Labeling of Dietary Supplements on a
"Per Day" Basis
FORMS: NONE
OMB NO: 0910-0396 EXPIRATION DATE: 02/28/2006
RESPS:1 HOURS:18,750 COSTS(000):$0
Financial Disclosure by Clinical Investigators
FORMS: 3454 3455
OMB NO: 0910-0409 EXPIRATION DATE: 09/30/2005
RESPS:2 HOURS:4,000 COSTS(000):$0
Regulations for In Vivo Radiopharmaceuticals Used for Diagnosis
and Monitoring
FORMS: NONE
OMB NO: 0910-0423 EXPIRATION DATE: 04/30/2003
RESPS:2 HOURS:247 COSTS(000):$0
New Drug and Biological Drug Products; Evidence Needed to
Demonstrate Efficacy of New Drugs for Use Against Lethal or
Permanently Disabling Toxic Substances When Efficacy Studies...
FORMS: NONE
OMB NO: 0910-0428 EXPIRATION DATE: 12/31/2005
RESPS:25 HOURS:25 COSTS(000):$0
Record Retention Requirements for the Soy Protein/CHD Health
Claim
FORMS: NONE
OMB NO: 0910-0429 EXPIRATION DATE: 02/28/2006
RESPS:3,103 HOURS:42,760 COSTS(000):$0
Guidance for Industry on Formal Mettings with Sponsors and
Applicants for PDUFA Products
FORMS: 1571 1572 356H
OMB NO: 0910-0430 EXPIRATION DATE: 02/28/2006
RESPS:3 HOURS:96 COSTS(000):$0
Guidance for Industry on Formal Dispute Resolutions; Appeals
Above the Division Level
FORMS: FDA-1571 FDA-356H
OMB NO: 0910-0431 EXPIRATION DATE: 03/31/2004
RESPS:12,278 HOURS:842,020 COSTS(000):$0
Changes to an Approved NDA or ANDA
FORMS: NONE
OMB NO: 0910-0432 EXPIRATION DATE: 01/31/2006
RESPS:2 HOURS:1,082 COSTS(000):$0
Medical Device Recall Authority
FORMS: NONE
OMB NO: 0910-0433 EXPIRATION DATE: 02/29/2004
RESPS:548 HOURS:4,384 COSTS(000):$0
Postmarketing Studies for Human Drugs and Licensed Biological
Products; Status Reports
FORMS: FDA-2252
OMB NO: 0910-0435 EXPIRATION DATE: 05/31/2003
RESPS:96,935,065 HOURS:3,361,996 COSTS(000):$0
Prescription Drug Marketing Act of 1987; Policies, Requirements,
and Administrative Procedures
FORMS: NONE
OMB NO: 0910-0437 EXPIRATION DATE: 04/30/2003
RESPS:39,764 HOURS:91,306 COSTS(000):$0
Medical Devices; Medical Device Reporting;manufacturer
reportiing importer reporting, user facility reporting,
distributor reporting
FORMS: FDA-3419 FDA-3417
OMB NO: 0910-0439 EXPIRATION DATE: 04/30/2003
RESPS:265 HOURS:3,710 COSTS(000):$0
Aluminum in Large and Small Volume Parenterals Used in Total
Parenteral Nutrition
FORMS: NONE
OMB NO: 0910-0442 EXPIRATION DATE: 04/30/2005
RESPS:10,174,876 HOURS:2,790,329 COSTS(000):$0
Medical Device Tracking Regulations
FORMS: NONE
OMB NO: 0910-0443 EXPIRATION DATE: 06/30/2003
RESPS:1 HOURS:250 COSTS(000):$0
Survey of Incidence of Gastroenterolocial Parasitic Infections
in the United States as a Result of Consumption of Raw Fish
FORMS: NONE
OMB NO: 0910-0445 EXPIRATION DATE: 09/30/2003
RESPS:182 HOURS:51,688 COSTS(000):$0
Submitting and Reviewing Complete Responses to Clinical Holds;
Guidance for Industry
FORMS: NONE
OMB NO: 0910-0448 EXPIRATION DATE: 11/30/2003
RESPS:1,000 HOURS:1,000 COSTS(000):$0
Adoption of FDA Food Code by Local, State, and Tribal Governments
FORMS: NONE
OMB NO: 0910-0449 EXPIRATION DATE: 11/30/2003
RESPS:502 HOURS:23,328 COSTS(000):$0
Postmarket Surveillance
FORMS: NONE
OMB NO: 0910-0450 EXPIRATION DATE: 11/30/2003
RESPS:66 HOURS:27 COSTS(000):$0
Guidance for Industry on How to Use E-Mail to Submit a Notice of
Intent to Slaughter for Human Food Purposes
FORMS: 3487
OMB NO: 0910-0452 EXPIRATION DATE: 11/30/2003
RESPS:168 HOURS:116 COSTS(000):$0
Guidance for Industry on How to Use E-Mail to Submit a Request
for a Meeting or Teleconference to the Office of New Animal Drug
Evaluation
FORMS: FDA-3488
OMB NO: 0910-0453 EXPIRATION DATE: 11/30/2003
RESPS:324 HOURS:262 COSTS(000):$0
Guidance for Industry on How to Use E-Mail to Submit a Notice of
Final Disposition of Animals Not Inded for Immediate Slaughter
FORMS: FDA-3486
OMB NO: 0910-0454 EXPIRATION DATE: 11/30/2003
RESPS:140 HOURS:140 COSTS(000):$0
Guidance: How to Use E-Mail to Submit Information to the Center
for Veterinary Medicine
FORMS: NONE
OMB NO: 0910-0455 EXPIRATION DATE: 11/30/2003
RESPS:83 HOURS:1,529 COSTS(000):$1
Documentation for demonstrating compliance with the Channels
FORMS: NONE
OMB NO: 0910-0456 EXPIRATION DATE: 01/31/2004
RESPS:53 HOURS:343 COSTS(000):$0
PHS (Public Health Service) Guideline on Infectious Disease
Issues in Xenotransplantation
FORMS: NONE
OMB NO: 0910-0457 EXPIRATION DATE: 03/31/2005
RESPS:2,000 HOURS:1,000 COSTS(000):$0
Rapid Response Surveys
FORMS: NONE
OMB NO: 0910-0458 EXPIRATION DATE: 02/29/2004
RESPS:60,751 HOURS:261,648 COSTS(000):$0
Biological Products: Reporting of Biological Product Deviations
FORMS: FDA-3486
OMB NO: 0910-0459 EXPIRATION DATE: 03/31/2004
RESPS:34,660 HOURS:202,496 COSTS(000):$0
Information Program on Clinical Trials for Serious and Life-
Threatening Diseases
FORMS: NONE
OMB NO: 0910-0461 EXPIRATION DATE: 02/29/2004
RESPS:10 HOURS:20 COSTS(000):$0
Substances Approved for Use in the Preparatin of Meat and
Poultry Products
FORMS: NONE
OMB NO: 0910-0466 EXPIRATION DATE: 03/31/2004
RESPS:15,035 HOURS:358,465 COSTS(000):$0
Hazard Analysis and Critical Control Point (HACCP) Procedures
for the Safe and Sanitary Processing of Juice (21 CFR Part 120)
FORMS: NONE
OMB NO: 0910-0467 EXPIRATION DATE: 04/30/2004
RESPS:6 HOURS:120 COSTS(000):$0
Request for Review of Scientific Disputes Concerning the
Regulation of Medical Devices
FORMS: NONE
OMB NO: 0910-0469 EXPIRATION DATE: 07/31/2004
RESPS:1,225 HOURS:1,525 COSTS(000):$0
Human Cells, Tissues, and Cellular and Tissue-Based Products;
Establishments Registration and Listing; Final Rule
FORMS: FDA-3356
OMB NO: 0910-0470 EXPIRATION DATE: 07/31/2004
RESPS:240 HOURS:3,180 COSTS(000):$0
Guidance for Industry on Special Protocol Assessment
FORMS: NONE
OMB NO: 0910-0471 EXPIRATION DATE: 07/31/2004
RESPS:1,245 HOURS:934 COSTS(000):$0
Adverse Event Pilot Program for Medical Devices
FORMS: NONE
OMB NO: 0910-0472 EXPIRATION DATE: 08/31/2004
RESPS:29,356 HOURS:3,125 COSTS(000):$0
Requirements for Testing Human Blood Donors for Evidence of
Infection Due to Communicable Disease Agents
FORMS: NONE
OMB NO: 0910-0474 EXPIRATION DATE: 08/31/2004
RESPS:416,021 HOURS:141,681 COSTS(000):$0
General Requirements for Blood, Blood Components, and Blood
Derivatives; Donor Notification
FORMS: NONE
OMB NO: 0910-0477 EXPIRATION DATE: 10/31/2004
RESPS:5,272 HOURS:659 COSTS(000):$0
Survey of Single-Use Medical Device (SUD) Reuse and Reprocessing
in Hospitals
FORMS: NONE
OMB NO: 0910-0478 EXPIRATION DATE: 05/31/2003
RESPS:5,000 HOURS:6,500 COSTS(000):$0
Consumer and Producer Surveys on Economic Issues
FORMS: NONE
OMB NO: 0910-0479 EXPIRATION DATE: 06/30/2003
RESPS:1 HOURS:637 COSTS(000):$0
Assessment of Physician and Patient Attitudes Toward
Direct-to-Consumer (DTC) Promotion of Prescription Drugs
FORMS: NONE
OMB NO: 0910-0480 EXPIRATION DATE: 11/30/2003
RESPS:3 HOURS:17,403 COSTS(000):$56
Providing Regulatory Submissions in Electronic Format for Food
Additive and Color Additive Petitions
FORMS: FDA-3503 FDA-3504
OMB NO: 0910-0482 EXPIRATION DATE: 01/31/2005
RESPS:2,065 HOURS:31,106 COSTS(000):$0
Exports: Notification and Recordkeeping Requirements
FORMS: NONE
OMB NO: 0910-0483 EXPIRATION DATE: 03/31/2005
RESPS:108,148 HOURS:52,333 COSTS(000):$0
Foreign Establishment Registration and Listing
FORMS: FDA-2656 -2830 -2891
OMB NO: 0910-0484 EXPIRATION DATE: 03/31/2005
RESPS:307 HOURS:1,417 COSTS(000):$0
Suggested Documentation for Demonstrating Compliance with
Channels of Trade Provision for Foods with Vinclozolin Residues
FORMS: NONE
OMB NO: 0910-0485 EXPIRATION DATE: 03/31/2005
RESPS:2,320,385 HOURS:3,191,305 COSTS(000):$0
Medical Device Labeling Regulations
FORMS: NONE
OMB NO: 0910-0486 EXPIRATION DATE: 04/30/2005
RESPS:53 HOURS:813 COSTS(000):$1
Requirements for States as Certification Agencies
FORMS: NONE
OMB NO: 0910-0489 EXPIRATION DATE: 03/31/2005
RESPS:2,000 HOURS:922 COSTS(000):$0
Health and Diet Survey
FORMS: NONE
OMB NO: 0910-0492 EXPIRATION DATE: 01/31/2004
RESPS:7,000 HOURS:4,000 COSTS(000):$0
Consumer Surveys on Food and Dietary Supplement Labeling Issues
FORMS: NONE
OMB NO: 0910-0493 EXPIRATION DATE: 09/30/2005
RESPS:12 HOURS:960 COSTS(000):$0
Salmonella Discovery System Pilot Study
FORMS: NONE
OMB NO: 0910-0494 EXPIRATION DATE: 04/30/2003
RESPS:1,200 HOURS:300 COSTS(000):$0
The Evaluation of Long-Term Antibiotic Drug Therapy for Persons
Involved in Anthrax Remediation Activities
FORMS: NONE
OMB NO: 0910-0495 EXPIRATION DATE: 11/30/2005
RESPS:1,216 HOURS:35,700 COSTS(000):$38,875
Food Additives; Food Contact Substances Notification System
FORMS: 3479 3480
OMB NO: 0910-0497 EXPIRATION DATE: 05/31/2004
RESPS:1,683 HOURS:3,352 COSTS(000):$0
Focus Groups as Used by the Food and Drug Administration
FORMS: NONE
OMB NO: 0910-0498 EXPIRATION DATE: 11/30/2005
RESPS:9,787 HOURS:13,287 COSTS(000):$766
Export Certificates for FDA Regulated Products Under U.S.C.
Sections 801(e) and 802
FORMS: NONE
OMB NO: 0910-0500 EXPIRATION DATE: 06/30/2004
RESPS:30 HOURS:3,000 COSTS(000):$0
FDA Rapid Response Surveys
FORMS: NONE
OMB NO: 0910-0501 EXPIRATION DATE: 06/30/2004
RESPS:1 HOURS:112 COSTS(000):$0
Telephone Questionnaire Administration to Control Subjects
Recruited into FDA Lyme Vaccine Safety Study, "A Case-Control
Study of HLA Type and T-Cell Reactivity to Recombinat Outer.....
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
146 216,619,428 75,377,571 $139,574
Health Services Administration
OMB NO: 0915-0028 EXPIRATION DATE: 03/31/2004
RESPS:80 HOURS:14 COSTS(000):$0
Scholarship Program for Students of Exceptional Financial Need
(EFN) and Program of Financial Assistance for Disadvantages Heal
Professions Students (FADHPS) Application
FORMS: HRSA-525
OMB NO: 0915-0034 EXPIRATION DATE: 07/31/2003
RESPS:227,552 HOURS:13,703 COSTS(000):$0
Health Education Assistance Loan (HEAL) Program: Forms
FORMS: HRSA-504 HRSA-508
OMB NO: 0915-0036 EXPIRATION DATE: 08/31/2005
RESPS:26,700 HOURS:4,958 COSTS(000):$11
Health Education Assistance Loan (HEAL) Program: Lender's
Application for Insurance Claim Form and Request for Collection
Assistance Form
FORMS: 510 513
OMB NO: 0915-0043 EXPIRATION DATE: 10/31/2003
RESPS:12,088 HOURS:6,066 COSTS(000):$0
Health Education Assistance Loan (HEAL) Program Information
Collection Requirements - Forms
FORMS: HRSA-502-1 HRSA-502-2 HRSA-512
OMB NO: 0915-0044 EXPIRATION DATE: 01/31/2006
RESPS:7,048 HOURS:5,192 COSTS(000):$0
Health Professions Student Loan and Nursing Student Loan
Programs-Forms
FORMS: HRSA-501 HRSA-519
OMB NO: 0915-0047 EXPIRATION DATE: 08/31/2005
RESPS:92,571 HOURS:37,428 COSTS(000):$0
Health Professions Student Loan (HPSL) Program and Nursing
Student Loan (NSL) Program: Admin. Requirements (Regs. & Policy)
FORMS: NONE
OMB NO: 0915-0060 EXPIRATION DATE: 06/30/2003
RESPS:12,540 HOURS:70,313 COSTS(000):$27
HRSA Competing Training Grant Application
FORMS: PHS-6025-1
OMB NO: 0915-0061 EXPIRATION DATE: 04/30/2003
RESPS:626 HOURS:6,260 COSTS(000):$0
The Uniform Progress Reports (UPR) for HRSA Continuation
Training Grants
FORMS: NONE
OMB NO: 0915-0077 EXPIRATION DATE: 02/28/2006
RESPS:82,197 HOURS:48,072 COSTS(000):$0
Uncompensated Services Assurance Report
FORMS: HRSR-710
OMB NO: 0915-0081 EXPIRATION DATE: 07/31/2003
RESPS:14 HOURS:1 COSTS(000):$0
Black Lung Clinics Program (42 CFR 55a and Program Guidelines)
FORMS: NONE
OMB NO: 0915-0099 EXPIRATION DATE: 11/30/2003
RESPS:20 HOURS:60 COSTS(000):$0
Grants for Hospital Construction and Modernization - Federal
Rights of Recovery and Waiver of Recovery (42 CFR 124, Subpart H)
FORMS: NONE
OMB NO: 0915-0108 EXPIRATION DATE: 12/31/2003
RESPS:504,661 HOURS:95,290 COSTS(000):$0
Health Education Assistance Loan (HEAL) Program Regulation - 42
CFR Part 60
FORMS: NONE
OMB NO: 0915-0126 EXPIRATION DATE: 01/31/2004
RESPS:2,443,091 HOURS:304,398 COSTS(000):$13,508
National Practitioner Data Bank for Adverse Information on
Physicians and Other Health Care Practitioners: Regulations and
Forms
FORMS: NONE
OMB NO: 0915-0127 EXPIRATION DATE: 04/30/2005
RESPS:845 HOURS:1,211 COSTS(000):$0
The National Health Service Corps (NHSC) Loan Repayment Program
FORMS: NONE
OMB NO: 0915-0140 EXPIRATION DATE: 03/31/2004
RESPS:1,050 HOURS:1,050 COSTS(000):$3
Nursing Education Loan Repayment Agreements
FORMS: NONE
OMB NO: 0915-0142 EXPIRATION DATE: 08/31/2005
RESPS:100 HOURS:4,000 COSTS(000):$1
Application for Certification as a Federall Qualified Health
Center Look-Alike
FORMS: NONE
OMB NO: 0915-0146 EXPIRATION DATE: 07/31/2003
RESPS:3,100 HOURS:3,100 COSTS(000):$8
The Application for Participation in the National Health Service
Corps Scholarship Program
FORMS: HRSA-856
OMB NO: 0915-0149 EXPIRATION DATE: 11/30/2003
RESPS:450 HOURS:12,600 COSTS(000):$0
Scholarships for Disadvantaged Students Applications
FORMS: NONE
OMB NO: 0915-0150 EXPIRATION DATE: 12/31/2003
RESPS:94 HOURS:94 COSTS(000):$0
Faculty Loan Repayment Program Application
FORMS: HRSA-535
OMB NO: 0915-0151 EXPIRATION DATE: 02/28/2005
RESPS:125 HOURS:2,375 COSTS(000):$0
Ryan White CARE Act Dental Reimbursement Program
FORMS: NONE
OMB NO: 0915-0157 EXPIRATION DATE: 06/30/2004
RESPS:517,693 HOURS:80,362 COSTS(000):$0
Organ Procurement and Transplantation Network and Scientific
Registry of Transplan Recipients Data System
FORMS: NONE
OMB NO: 0915-0158 EXPIRATION DATE: 12/31/2003
RESPS:278 HOURS:22,240 COSTS(000):$0
Grantee Reporting Requirements for the Ryan White Comprehensive
AIDS Resources Emergency Act of 1990 - Title III
FORMS: NONE
OMB NO: 0915-0172 EXPIRATION DATE: 04/30/2003
RESPS:59 HOURS:19,858 COSTS(000):$0
Maternal and Child Health Services Block Grant Annual Report,
Needs Assessment and Application Guidance
FORMS: NONE
OMB NO: 0915-0174 EXPIRATION DATE: 06/30/2003
RESPS:150 HOURS:150 COSTS(000):$0
Loan Information System Records for the DHHS and DHUD Hospital
Mortgage Insurance, Guarantee, and Direct Loan Programs
FORMS: HRSA-906
OMB NO: 0915-0176 EXPIRATION DATE: 10/31/2003
RESPS:9 HOURS:94 COSTS(000):$0
Drug Pricing Program Reporting Requirements
FORMS: NONE
OMB NO: 0915-0179 EXPIRATION DATE: 02/29/2004
RESPS:700 HOURS:700 COSTS(000):$0
Deferment Request Form for the National Health Service Corps
Scholarship Program
FORMS: NONE
OMB NO: 0915-0184 EXPIRATION DATE: 06/30/2004
RESPS:36,460 HOURS:4,862 COSTS(000):$0
Organ Procurement and Transplantation Network
FORMS: NONE
OMB NO: 0915-0185 EXPIRATION DATE: 04/30/2004
RESPS:550 HOURS:343 COSTS(000):$0
Pilot Test of the Community Health Center/National Health
Service Corp User/Visit Survey
FORMS: NONE
OMB NO: 0915-0186 EXPIRATION DATE: 01/31/2005
RESPS:2,785 HOURS:9,142 COSTS(000):$0
Main Study of the Community Health Center/National Health
Service Corps Site User/Visit Survey
FORMS: NONE
OMB NO: 0915-0188 EXPIRATION DATE: 10/31/2004
RESPS:265 HOURS:530 COSTS(000):$10
Data Collection and Reporting Requirements for Healty Schools,
Healthy Communities
FORMS: NONE
OMB NO: 0915-0193 EXPIRATION DATE: 11/30/2003
RESPS:757 HOURS:19,992 COSTS(000):$80,917
Uniform Data System
FORMS: NONE
OMB NO: 0915-0204 EXPIRATION DATE: 03/31/2004
RESPS:351 HOURS:88 COSTS(000):$2
Health Education Assistant Loan (HEAL) Program: Physicians's
Certification of Borrower's Total and Permanent Disability Form
FORMS: HRSA-539
OMB NO: 0915-0206 EXPIRATION DATE: 12/31/2003
RESPS:178 HOURS:9,714 COSTS(000):$403
Ryan White Comprehensive AIDS Resources Emergency Act of 1990,
Amended 1996 - Title IV
FORMS: NONE
OMB NO: 0915-0208 EXPIRATION DATE: 09/30/2003
RESPS:311 HOURS:26 COSTS(000):$0
Professional Training and Information Questionnaire
FORMS: HRSA-551 HRSA-552
OMB NO: 0915-0212 EXPIRATION DATE: 03/31/2006
RESPS:52,050 HOURS:5,075 COSTS(000):$0
Voluntary Partner Surveys to Implement Executive Order 12862 in
the Health Resources and Services Administration
FORMS: NONE
OMB NO: 0915-0219 EXPIRATION DATE: 11/30/2003
RESPS:864 HOURS:648 COSTS(000):$0
AIDS Drug Assistance Program Monthly Report for Ryan White
Comprehensive AIDS Resources Emergency Act Amendments of 1996,
Titles I and II
FORMS: NONE
OMB NO: 0915-0226 EXPIRATION DATE: 10/31/2004
RESPS:1 HOURS:300 COSTS(000):$0
NHSC and Native Hawaiian Health Scholarship Programs Data
Collection Worksheet
FORMS: NONE
OMB NO: 0915-0227 EXPIRATION DATE: 10/31/2004
RESPS:3,704 HOURS:1,297 COSTS(000):$0
Health Education Assistance Loan (HEAL) Program: Refinancing
Application/Promissory Note
FORMS: HRSA-550
OMB NO: 0915-0230 EXPIRATION DATE: 04/30/2005
RESPS:1,200 HOURS:300 COSTS(000):$0
NHSC Recruitment and Retention Assistance Application
FORMS: NONE
OMB NO: 0915-0232 EXPIRATION DATE: 04/30/2005
RESPS:900 HOURS:24,300 COSTS(000):$33
National Health Service Corps - Uniform Data System
FORMS: NONE
OMB NO: 0915-0233 EXPIRATION DATE: 04/30/2005
RESPS:150 HOURS:150 COSTS(000):$0
Disadvantaged Assistance Tracking and Outcome Report (DATOR) for
Health Careers Opportunity Program and Centers of Excellence
Program
FORMS: NONE
OMB NO: 0915-0234 EXPIRATION DATE: 09/30/2005
RESPS:2,400 HOURS:1,200 COSTS(000):$0
NHSC Waiver Request Worksheets
FORMS: HRSA-553 HRSA-554
OMB NO: 0915-0239 EXPIRATION DATE: 03/31/2004
RESPS:1,282,004 HOURS:187,169 COSTS(000):$2,107
Healthcare Integrity and Protection Data Bank for Final Adverse
Information on Health Care Providers, Suppliers and
Practitioners (45 CFR 61)
FORMS: NONE
OMB NO: 0915-0244 EXPIRATION DATE: 12/31/2003
RESPS:2,025 HOURS:4,725 COSTS(000):$0
Ricky Ray Hemophilia Relief Fund Program
FORMS: NONE
OMB NO: 0915-0245 EXPIRATION DATE: 07/31/2003
RESPS:52,298 HOURS:26,149 COSTS(000):$0
They Ryan White CARE Act Client Demonstration Project Reporting
System
FORMS: NONE
OMB NO: 0915-0247 EXPIRATION DATE: 02/29/2004
RESPS:60 HOURS:3,600 COSTS(000):$0
Children's Hospital Graduate Medical Education Program
FORMS: NONE
OMB NO: 0915-0248 EXPIRATION DATE: 08/31/2003
RESPS:420 HOURS:139 COSTS(000):$0
The Impact of the State Child Health Insurance Program on
Selected Community Health Centers and Maternal and Child Health
Programs
FORMS: NONE
OMB NO: 0915-0250 EXPIRATION DATE: 02/29/2004
RESPS:1,350 HOURS:276 COSTS(000):$0
The National Health Service Corps Scholarship Program In-School
Worksheets
FORMS: NONE
OMB NO: 0915-0253 EXPIRATION DATE: 08/31/2004
RESPS:2,586 HOURS:96,600 COSTS(000):$0
Ryan White Comprehensive Aids Resources Emergency Act of 1990,
Cross-Title Data Report (CTDR) System
FORMS: NONE
OMB NO: 0915-0254 EXPIRATION DATE: 10/31/2004
RESPS:18,671 HOURS:13,440 COSTS(000):$0
U.S. Component of the 2001/2002 World Health Organization Study
of Health Behavior in School Children (WHO-HPSC)
FORMS: NONE
OMB NO: 0915-0256 EXPIRATION DATE: 09/30/2004
RESPS:5 HOURS:35 COSTS(000):$0
Charitable Facility Compliance Alternative (amended) - Final Rule
FORMS: NONE
OMB NO: 0915-0260 EXPIRATION DATE: 04/30/2005
RESPS:1,000 HOURS:750 COSTS(000):$0
Healthy Schools, Healthy Communities User/Visit Surveys
FORMS: NONE
OMB NO: 0915-0261 EXPIRATION DATE: 05/31/2005
RESPS:400 HOURS:400 COSTS(000):$0
Hepatitis B and C Among Health Care for the Homeless Program
Clients
FORMS: NONE
OMB NO: 0915-0262 EXPIRATION DATE: 06/30/2005
RESPS:212 HOURS:3,816 COSTS(000):$0
Office of State and National Partnership's Web-based Semi Annual
Report
FORMS: NONE
OMB NO: 0915-0263 EXPIRATION DATE: 07/31/2003
RESPS:52 HOURS:442 COSTS(000):$0
A Needs Assessment of the Black Lung Clinics Program
FORMS: NONE
OMB NO: 0915-0265 EXPIRATION DATE: 10/31/2003
RESPS:11,250 HOURS:1,000 COSTS(000):$0
Survey on Gender, Ethnic and Racial Backgrounds of Clients and
Staff at Bureau of Primary Health Care Supported Community-Based
Health Service Sites
FORMS: HRSA-105 HRSA-106
OMB NO: 0915-0266 EXPIRATION DATE: 11/30/2004
RESPS:743 HOURS:808 COSTS(000):$0
Private Health Insurance Coverage of Immunosuppressive Drugs
Survey
FORMS: NONE
OMB NO: 0915-0268 EXPIRATION DATE: 12/31/2005
RESPS:152 HOURS:1,216 COSTS(000):$0
Implementation of the Primary Care Surveillance System (PSCC)
Core Data Collection Effort for the Sentinal Centers Network
(SCN)
FORMS: NONE
OMB NO: 0915-0269 EXPIRATION DATE: 12/31/2004
RESPS:2,010 HOURS:505 COSTS(000):$0
Evaluation of the Health Care for the Homeless (HCH) Respite
Pilot Initiative
FORMS: NONE
OMB NO: 0915-0270 EXPIRATION DATE: 03/31/2006
RESPS:1,752 HOURS:483 COSTS(000):$0
Evaluation of the Infant Adoption Awareness Training Program
FORMS: NONE
OMB NO: 0915-0271 EXPIRATION DATE: 03/31/2004
RESPS:56 HOURS:168 COSTS(000):$0
Emergency Medical Services for Children (EMSC) Annual Grantee
Survey
FORMS: NONE
OMB NO: 0915-0272 EXPIRATION DATE: 01/31/2006
RESPS:750 HOURS:4,500 COSTS(000):$0
Maternal and Child Health Bureau Common Grant Guidance for
Discretionay Grants
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
62 5,414,563 1,163,777 $97,030
Indian Health Service
OMB NO: 0917-0002 EXPIRATION DATE: 04/30/2003
RESPS:327,114 HOURS:20,778 COSTS(000):$0
IHS Contract Health Service Report
FORMS: IHS-843-1A
OMB NO: 0917-0006 EXPIRATION DATE: 12/31/2004
RESPS:15,830 HOURS:7,356 COSTS(000):$0
IHS Scholarship Program Application
FORMS: IHS-856 856-2--856-8 IHS-815-818 D-02 F-02 F-04 G-02 G-04 H-07
H-08
OMB NO: 0917-0007 EXPIRATION DATE: 12/31/2003
RESPS:261 HOURS:313 COSTS(000):$0
IHS Urban Indian Health Program Common Reporting Requirements
FORMS: NONE
OMB NO: 0917-0009 EXPIRATION DATE: 05/31/2003
RESPS:3,709 HOURS:2,371 COSTS(000):$0
IHS Medical Staff Credentials and Privileges File
FORMS: NONE
OMB NO: 0917-0014 EXPIRATION DATE: 12/31/2005
RESPS:2,125 HOURS:1,381 COSTS(000):$0
Indian Health Service Loan Repayment Program
FORMS: NONE
OMB NO: 0917-0022 EXPIRATION DATE: 07/31/2003
RESPS:475 HOURS:236 COSTS(000):$0
Evaluation of the Indian Health Service/Bureau of Indian Affairs
Training Practitioners Project
FORMS: NONE
OMB NO: 0917-0024 EXPIRATION DATE: 05/31/2005
RESPS:7,500 HOURS:1,875 COSTS(000):$0
IHS Customer Satisfaction Survey
FORMS: NONE
OMB NO: 0917-0025 EXPIRATION DATE: 11/30/2003
RESPS:1 HOURS:384 COSTS(000):$0
Hoz'ho'nii: An Intervention to Increase Breast and Cervical
Cancer Screening Among Navajo Women
FORMS: NONE
OMB NO: 0917-0026 EXPIRATION DATE: 07/31/2005
RESPS:1 HOURS:3,720 COSTS(000):$0
Final Rule to Implement Title V of the Tribal Self-Governance
Amendments of 2000
FORMS: NONE
OMB NO: 0917-0027 EXPIRATION DATE: 08/31/2005
RESPS:1 HOURS:202 COSTS(000):$0
Stakeholder Satisfaction with IHS Tribal Consultation
FORMS: NONE
OMB NO: 0917-0028 EXPIRATION DATE: 11/30/2005
RESPS:2,000 HOURS:500 COSTS(000):$20,000
IHS Background Investigatins of Individuals in Positins
Involving Regular Contact with or Control Over Indian Children
FORMS: OPM-306
OMB NO: 0917-0030 EXPIRATION DATE: 09/30/2003
RESPS:542,500 HOURS:174,375 COSTS(000):$0
IHS Forms To Implement The Privacy Rules (43 CFR Parts 160 and
164)
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
12 901,517 213,491 $20,000
Centers for Disease Control and Prevention
OMB NO: 0920-0004 EXPIRATION DATE: 04/30/2003
RESPS:326 HOURS:2,650 COSTS(000):$0
National Disease Surveillance Program II; Disease Summaries
FORMS: CDC52.12 52.13 52.19 52.20 52.28 55.41 55.3 55.9/55.20
55.31/55.31A 55.83A-C
OMB NO: 0920-0006 EXPIRATION DATE: 05/31/2005
RESPS:200 HOURS:167 COSTS(000):$0
Statements in Support of Application for Waiver of
Inadmissibility under Section 212(a)(1)(A)(i) or 212 (a)(1)(A)
(iii)(1) or (11)of Immigration and Nationality Act
FORMS: CDC-4.422-1 CDC-4.422-1A CDC-4.422-1B
OMB NO: 0920-0007 EXPIRATION DATE: 12/31/2003
RESPS:9,365 HOURS:4,927 COSTS(000):$0
Weekly and Annual Morbidity and Mortality Reports
FORMS: CDC-43.5A
OMB NO: 0920-0008 EXPIRATION DATE: 06/30/2003
RESPS:12,000 HOURS:3,000 COSTS(000):$0
Emergency Epidemic Investigations
FORMS: NONE
OMB NO: 0920-0009 EXPIRATION DATE: 02/28/2006
RESPS:51,330 HOURS:14,430 COSTS(000):$0
National Disease Surveillance Program - 1. Case Reports
FORMS: CDC-53.1 CDC-52.15 CDC-56.31A CDC-56.31B CDC-55.54 CDC-52-56
CDC-52.18 CDC-52.60 CDC-54.1 CDC-56.37
OMB NO: 0920-0010 EXPIRATION DATE: 02/28/2006
RESPS:400 HOURS:600 COSTS(000):$0
National Birth Defects Prevention Study
FORMS: NONE
OMB NO: 0920-0012 EXPIRATION DATE: 09/30/2003
RESPS:92,542 HOURS:71,259 COSTS(000):$100
National Nosocomial Infections Surveillance (NNIS) System
FORMS: 57.65 57.66 57.58D 57.58B 57.58H 57.58G 57.58C 57.64A 57.68
57.69/57.70
OMB NO: 0920-0017 EXPIRATION DATE: 04/30/2003
RESPS:55,025 HOURS:4,590 COSTS(000):$0
Application for Training
FORMS: 32.1 36.5
OMB NO: 0920-0020 EXPIRATION DATE: 05/31/2004
RESPS:31,150 HOURS:4,791 COSTS(000):$0
X-Ray Examination Program (42 CFR Part 37)
FORMS: CDC/NIOSH(M)2.8 (M)2.10 (M)2.11 (M)2.12
OMB NO: 0920-0021 EXPIRATION DATE: 04/30/2003
RESPS:150 HOURS:62 COSTS(000):$0
Regulation 42 CFR 37.204 -- National Coal Workers' Autopsy Study
FORMS: NONE
OMB NO: 0920-0026 EXPIRATION DATE: 09/30/2005
RESPS:16,675 HOURS:8,338 COSTS(000):$0
Report of Verified Case of Tuberculosis
FORMS: 72.9 72.9A 72.9B 72.9C
OMB NO: 0920-0033 EXPIRATION DATE: 11/30/2005
RESPS:3,800 HOURS:3,800 COSTS(000):$0
National Surveillance of Dialysis-Associated Diseases
FORMS: NONE
OMB NO: 0920-0102 EXPIRATION DATE: 01/31/2005
RESPS:450 HOURS:90 COSTS(000):$0
Contents of a Request for Health Hazard Evaluation -- 42 CFR
85.3-1
FORMS: NONE
OMB NO: 0920-0106 EXPIRATION DATE: 01/31/2005
RESPS:122 HOURS:4,270 COSTS(000):$0
Preventive Health and Health Services Block Grant
FORMS: NONE
OMB NO: 0920-0109 EXPIRATION DATE: 08/31/2004
RESPS:427 HOURS:97,783 COSTS(000):$0
Tests and Requirements for Certification and Approval of
Respoiratory Protective Devices (42 CFR 84)
FORMS: NONE
OMB NO: 0920-0128 EXPIRATION DATE: 07/31/2003
RESPS:1,000 HOURS:260 COSTS(000):$0
Congenital Syphilis (CS) Case Investigation and Report Form
FORMS: CDC-73.126
OMB NO: 0920-0134 EXPIRATION DATE: 09/30/2004
RESPS:1,923 HOURS:119 COSTS(000):$0
Foreign Quarantine Regulations
FORMS: CDC-75.10A CDC-75.37
OMB NO: 0920-0138 EXPIRATION DATE: 12/31/2004
RESPS:70 HOURS:66 COSTS(000):$0
Pulmonary Function Testing Course Approval Program
FORMS: NONE
OMB NO: 0920-0199 EXPIRATION DATE: 06/30/2003
RESPS:5,370 HOURS:1,925 COSTS(000):$0
Importation of etiological agents and packaging and handling of
infectious substances and select agents
FORMS: CDC-0.753 CDC-0.1241 APPLICATION
OMB NO: 0920-0208 EXPIRATION DATE: 07/31/2003
RESPS:260 HOURS:184 COSTS(000):$0
HIV Prevention and Surveillance Project Reports
FORMS: NONE
OMB NO: 0920-0210 EXPIRATION DATE: 10/31/2003
RESPS:48 HOURS:1,788 COSTS(000):$0
List of Ingredients Added to Tobacco in the Manufacture
FORMS: NONE
OMB NO: 0920-0212 EXPIRATION DATE: 08/31/2005
RESPS:51,781 HOURS:2,653 COSTS(000):$0
National Hospital Discharge Survey
FORMS: NONE
OMB NO: 0920-0213 EXPIRATION DATE: 04/30/2003
RESPS:1,880 HOURS:418 COSTS(000):$0
National Vital Statistics Report Forms
FORMS: CDC-64.146 CDC-64.147
OMB NO: 0920-0214 EXPIRATION DATE: 04/30/2004
RESPS:39,000 HOURS:48,600 COSTS(000):$0
National Health Interview Survey: 2003 Basic Module with Topical
Modules
FORMS: NONE
OMB NO: 0920-0215 EXPIRATION DATE: 11/30/2004
RESPS:780 HOURS:227 COSTS(000):$0
Application Form and Related Forms for the Operation of the
National Death Index
FORMS: CDC/NCHS-6205-1 CDC-6425 CDC-6426 PHS-6205-3
OMB NO: 0920-0217 EXPIRATION DATE: 06/30/2004
RESPS:157 HOURS:44 COSTS(000):$0
NCHS Vital Statistics Training Form
FORMS: CDC-64.52
OMB NO: 0920-0222 EXPIRATION DATE: 02/29/2004
RESPS:550 HOURS:600 COSTS(000):$0
Questionnaire Research Design Laboratory
FORMS: NONE
OMB NO: 0920-0234 EXPIRATION DATE: 09/30/2003
RESPS:70,800 HOURS:6,177 COSTS(000):$0
Medical Care Survey 2001-2002
FORMS: CDC-64.148 CDC-64.149
OMB NO: 0920-0237 EXPIRATION DATE: 05/31/2005
RESPS:13,333 HOURS:56,013 COSTS(000):$0
National Health and Nutrition Examination Survey (NHANES)
FORMS: NONE
OMB NO: 0920-0260 EXPIRATION DATE: 06/30/2004
RESPS:11,350 HOURS:4,093 COSTS(000):$0
Health Hazard Evaluations/Technical Assistance and Emerging
Problems
FORMS: NONE
OMB NO: 0920-0261 EXPIRATION DATE: 01/31/2004
RESPS:61 HOURS:6,150 COSTS(000):$0
NIOSH Training Grants, 42 CFR Part 86, Application and
Regulations
FORMS: CDC-2.145A CDC-2.145B
OMB NO: 0920-0262 EXPIRATION DATE: 06/30/2004
RESPS:3,625 HOURS:3,625 COSTS(000):$0
Supplement to HIV/AIDS Surveillance (SHAS) Project
FORMS: NONE
OMB NO: 0920-0263 EXPIRATION DATE: 02/28/2005
RESPS:100 HOURS:20 COSTS(000):$0
Requirements for a Special Permit to Import Cynomolgus, African
Green, and Rhesus Monkeys into the United States
FORMS: NONE
OMB NO: 0920-0274 EXPIRATION DATE: 08/31/2004
RESPS:4,548 HOURS:852 COSTS(000):$0
CDC Model Performance Evaluation Program (MPEP) for Retroviral
and AIDS-Related
FORMS: NONE
OMB NO: 0920-0278 EXPIRATION DATE: 04/30/2005
RESPS:145,688 HOURS:14,721 COSTS(000):$0
National Hospital Ambulatory Medical Care Survey
FORMS: 101(CDC-64.151) 101/U
OMB NO: 0920-0282 EXPIRATION DATE: 12/31/2003
RESPS:240 HOURS:480 COSTS(000):$0
CDC Childhood Lead Poisoning Prevention Program Quarterly Report
FORMS: NONE
OMB NO: 0920-0295 EXPIRATION DATE: 10/31/2005
RESPS:48,100 HOURS:1,342 COSTS(000):$0
National AIDS and STD Hotline Survey of Callers
FORMS: NONE
OMB NO: 0920-0307 EXPIRATION DATE: 11/30/2004
RESPS:1,308 HOURS:6,300 COSTS(000):$0
Gonococcal Isolate Surveillance Project
FORMS: CDC-73.60A 73.60B 73.60C
OMB NO: 0920-0314 EXPIRATION DATE: 09/30/2003
RESPS:52,000 HOURS:18,361 COSTS(000):$0
National Survey of Family Growth, Cycle 6 Main Study
FORMS: NONE
OMB NO: 0920-0322 EXPIRATION DATE: 02/28/2006
RESPS:300 HOURS:100 COSTS(000):$0
Cholera and other Vibrio Illness Surveillance Report
FORMS: 52.79
OMB NO: 0920-0337 EXPIRATION DATE: 06/30/2004
RESPS:188 HOURS:600 COSTS(000):$0
National Childhood blood Lead Surveillance System
FORMS: NONE
OMB NO: 0920-0338 EXPIRATION DATE: 10/31/2003
RESPS:7 HOURS:296 COSTS(000):$0
List of Ingredients Added to Tobacco in the Manufacture
FORMS: NONE
OMB NO: 0920-0353 EXPIRATION DATE: 10/31/2003
RESPS:62,000 HOURS:1,008 COSTS(000):$0
National Nursing Home Survey
FORMS: NONE
OMB NO: 0920-0401 EXPIRATION DATE: 06/30/2003
RESPS:4,500 HOURS:2,066 COSTS(000):$0
Longitudinal Studies of Chronic Fatigue Syndrome: Sedgwick
County Study 36-Month Follow-up
FORMS: NONE
OMB NO: 0920-0406 EXPIRATION DATE: 12/31/2004
RESPS:381,671 HOURS:150,606 COSTS(000):$0
State and Local Area Integrated Telephone Survey (SLAITS)
FORMS: NONE
OMB NO: 0920-0417 EXPIRATION DATE: 11/30/2003
RESPS:180,510 HOURS:37,397 COSTS(000):$10
National Surveillance System for Health Care Workers
FORMS: NONE
OMB NO: 0920-0427 EXPIRATION DATE: 04/30/2003
RESPS:500 HOURS:500 COSTS(000):$0
The Sentinel Surveillance for Chronic Liver Disease
FORMS: NONE
OMB NO: 0920-0428 EXPIRATION DATE: 02/28/2006
RESPS:16,994 HOURS:42,711 COSTS(000):$0
PHS Supplements to Application for Federal Assistance (SF 424)
FORMS: SF-424 PHS-5161-1 CDC.124(E) CDC.0113 OPHS-1
OMB NO: 0920-0442 EXPIRATION DATE: 12/31/2003
RESPS:223 HOURS:6,300 COSTS(000):$0
Surveillance for Bloodstream and Vascular Access Infections in
Outpatient Hemodialysis Centers
FORMS: NONE
OMB NO: 0920-0444 EXPIRATION DATE: 06/30/2005
RESPS:11 HOURS:18,766 COSTS(000):$0
Annual Submission of the Quantity of Nicotine Contained in
Smokeless Tobacco Products Manufactured, Imported, or Packaged
in the U.S.
FORMS: NONE
OMB NO: 0920-0449 EXPIRATION DATE: 09/30/2003
RESPS:13,000 HOURS:2,166 COSTS(000):$0
The Evaluation of Customer Satisfaction of the Internet Homepage
and Links for CDC and ATSDR
FORMS: NONE
OMB NO: 0920-0450 EXPIRATION DATE: 02/28/2006
RESPS:1,000 HOURS:1,625 COSTS(000):$0
Children's Longitudinal Development Study
FORMS: NONE
OMB NO: 0920-0461 EXPIRATION DATE: 04/30/2003
RESPS:3,130 HOURS:534 COSTS(000):$0
An Evaluation of Targeted Health Communication Messages: Folic
Acid and Neural Tube Defects
FORMS: NONE
OMB NO: 0920-0463 EXPIRATION DATE: 12/31/2005
RESPS:525 HOURS:263 COSTS(000):$0
Longitudinal Surveillance for Beryllium Disease Prevention
FORMS: NONE
OMB NO: 0920-0469 EXPIRATION DATE: 04/30/2003
RESPS:1 HOURS:126 COSTS(000):$0
National Program of Cancer Registries - Cancer Surveillance
System
FORMS: NONE
OMB NO: 0920-0470 EXPIRATION DATE: 07/31/2003
RESPS:880 HOURS:98 COSTS(000):$0
Possible Estuary Associated Syndrome (PEAS) Surveillance
FORMS: NONE
OMB NO: 0920-0472 EXPIRATION DATE: 06/30/2003
RESPS:2,360 HOURS:510 COSTS(000):$0
Assessment of Exposure to Arsenic through Household Water
FORMS: NONE
OMB NO: 0920-0473 EXPIRATION DATE: 06/30/2003
RESPS:880 HOURS:218 COSTS(000):$0
Surveillance and Evaluation of Plasma Donors for the Human
Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV)
FORMS: NONE
OMB NO: 0920-0475 EXPIRATION DATE: 06/30/2003
RESPS:190 HOURS:55 COSTS(000):$0
Evaluation of the Public Health Prevention Service (PHPS) Program
FORMS: NONE
OMB NO: 0920-0476 EXPIRATION DATE: 06/30/2003
RESPS:14,420 HOURS:2,403 COSTS(000):$0
Evaluation of Viral Hepatitis Education Materials
FORMS: NONE
OMB NO: 0920-0478 EXPIRATION DATE: 07/31/2003
RESPS:290 HOURS:83 COSTS(000):$0
Routine Evaluation of Ongoing NIOSH Worker Notifications
FORMS: NONE
OMB NO: 0920-0479 EXPIRATION DATE: 07/31/2003
RESPS:118 HOURS:236 COSTS(000):$1
Implementation of an Automated Management Information System
FORMS: NONE
OMB NO: 0920-0480 EXPIRATION DATE: 07/31/2003
RESPS:138 HOURS:138 COSTS(000):$0
An evaluation study of Tuberculosis Control and Prevention
measures in Large City and County Jails
FORMS: NONE
OMB NO: 0920-0482 EXPIRATION DATE: 08/31/2003
RESPS:600 HOURS:200 COSTS(000):$0
Silicosis No Mas!: Evaluation of Materials Used for Outreach to
Hispanic Construction Workers
FORMS: NONE
OMB NO: 0920-0485 EXPIRATION DATE: 08/31/2003
RESPS:1,824 HOURS:1,425 COSTS(000):$0
Evaluating National Dissemination Strategies for Effective HIV
Prevention Programs for Youth
FORMS: NONE
OMB NO: 0920-0487 EXPIRATION DATE: 04/30/2003
RESPS:203 HOURS:55 COSTS(000):$0
Microbial Contamination of Produce: A Field Study in the Lower
Rio Grande Valley, Texas
FORMS: NONE
OMB NO: 0920-0488 EXPIRATION DATE: 09/30/2003
RESPS:16,500 HOURS:3,600 COSTS(000):$0
Restrictions on Interstate Travel of Persons
FORMS: NONE
OMB NO: 0920-0493 EXPIRATION DATE: 11/30/2003
RESPS:12,345 HOURS:9,173 COSTS(000):$0
2001 and 2003 Youth Risk Behavior Surveys
FORMS: NONE
OMB NO: 0920-0494 EXPIRATION DATE: 03/31/2005
RESPS:1,220 HOURS:206 COSTS(000):$0
Exposure to Aerosolized Brevetoxins During Red Tide Events
FORMS: NONE
OMB NO: 0920-0495 EXPIRATION DATE: 12/31/2003
RESPS:3,300 HOURS:1,084 COSTS(000):$0
Workplace Exacerbation of Asthma
FORMS: NONE
OMB NO: 0920-0496 EXPIRATION DATE: 12/31/2003
RESPS:3,590 HOURS:1,498 COSTS(000):$0
A Message-Based Intervention for Technology Transfer
FORMS: NONE
OMB NO: 0920-0497 EXPIRATION DATE: 04/30/2004
RESPS:1,040 HOURS:1,248 COSTS(000):$0
Evaluating CDC Funded Health Department HIV Prevention Programs
FORMS: NONE
OMB NO: 0920-0499 EXPIRATION DATE: 03/31/2004
RESPS:64 HOURS:3,296 COSTS(000):$0
Jail STD Prevalence Monitoring System
FORMS: NONE
OMB NO: 0920-0501 EXPIRATION DATE: 04/30/2003
RESPS:1,620 HOURS:485 COSTS(000):$0
A Research Program to Develop Optimal NIOSH Alerts for
Occupational Safety and Health in Farming
FORMS: NONE
OMB NO: 0920-0502 EXPIRATION DATE: 02/29/2004
RESPS:25,200 HOURS:7,918 COSTS(000):$0
Racial and Ethnic Approaches to Community Health (REACH)
FORMS: NONE
OMB NO: 0920-0503 EXPIRATION DATE: 02/29/2004
RESPS:11,300 HOURS:10,525 COSTS(000):$0
The Incidence of Breast and Other Cancers Among Female Flight
Attendants
FORMS: NONE
OMB NO: 0920-0504 EXPIRATION DATE: 02/29/2004
RESPS:40,236 HOURS:13,607 COSTS(000):$0
Thyroid Disease in Persons Exposed to Radioactive Fallout from
Atomic Weapons Testing at the Nevada Test Site: Phase III
FORMS: NONE
OMB NO: 0920-0508 EXPIRATION DATE: 03/31/2004
RESPS:4,000 HOURS:1,666 COSTS(000):$0
Evaluation Research for the National Bone Health Campaign
FORMS: NONE
OMB NO: 0920-0510 EXPIRATION DATE: 04/30/2003
RESPS:680 HOURS:230 COSTS(000):$0
Evaluating the Role of Positive and Negative Emotion in
Promoting Hearing Conservation Behaviors Among Coal Miners
FORMS: NONE
OMB NO: 0920-0511 EXPIRATION DATE: 04/30/2003
RESPS:6,435 HOURS:285 COSTS(000):$0
Developing Communication to Reduce Workplace Violence and
FORMS: NONE
OMB NO: 0920-0512 EXPIRATION DATE: 06/30/2003
RESPS:4,960 HOURS:300 COSTS(000):$0
Preventing Latex Allergy Among Non-healthcare Workers
FORMS: NONE
OMB NO: 0920-0521 EXPIRATION DATE: 07/31/2003
RESPS:955 HOURS:455 COSTS(000):$0
National Survey of STD Services Provided to US College Students
FORMS: NONE
OMB NO: 0920-0525 EXPIRATION DATE: 10/31/2004
RESPS:980 HOURS:1,960 COSTS(000):$0
Assessing the Effectiveness of Community-Based Organizations for
Evaluation
FORMS: NONE
OMB NO: 0920-0526 EXPIRATION DATE: 11/30/2004
RESPS:2,456 HOURS:614 COSTS(000):$0
Evaluation of Viral Hepatitis B Educational Slide Materials
FORMS: NONE
OMB NO: 0920-0527 EXPIRATION DATE: 01/31/2005
RESPS:300 HOURS:350 COSTS(000):$0
Human Exposure to Cyanobacterial (Blue-green Algal) Toxins in
Drinking Water: Risk of Exposure to Microcystins from Public
Water Systems
FORMS: NONE
OMB NO: 0920-0530 EXPIRATION DATE: 05/31/2005
RESPS:15,000 HOURS:16,250 COSTS(000):$0
EEOICPA Dose Reconstruction Inerviews and Form
FORMS: OCAS-1
OMB NO: 0920-0533 EXPIRATION DATE: 04/30/2003
RESPS:900 HOURS:300 COSTS(000):$0
A Survey of Pediatricians' attitudes and practices about
promoting commmunication between parents and their children
about sexuality and sexual risk
FORMS: NONE
OMB NO: 0920-0535 EXPIRATION DATE: 09/30/2005
RESPS:1,152 HOURS:233 COSTS(000):$0
Evaluating Toolbox Training Safety Programs for Construction and
Mining
FORMS: NONE
OMB NO: 0920-0537 EXPIRATION DATE: 07/31/2003
RESPS:1,500 HOURS:3,000 COSTS(000):$0
Communicating NIOSH Safety Information to Youth
FORMS: NONE
OMB NO: 0920-0548 EXPIRATION DATE: 05/31/2005
RESPS:143 HOURS:48 COSTS(000):$0
National Telephone Survey of Urban Mosquito Control Programs
FORMS: NONE
OMB NO: 0920-0551 EXPIRATION DATE: 05/31/2005
RESPS:1,883 HOURS:1,993 COSTS(000):$0
NIOSH Research Study for the Prevention of Work-Related
Musculoskeletal Disorders
FORMS: NONE
OMB NO: 0920-0552 EXPIRATION DATE: 06/30/2005
RESPS:700 HOURS:140 COSTS(000):$0
Preventing Hearing Loss Among Construction Workers
FORMS: NONE
OMB NO: 0920-0555 EXPIRATION DATE: 07/31/2005
RESPS:1,167 HOURS:28,008 COSTS(000):$0
National Public Health Performance Standards Program Local
Public Health Performance Assessment
FORMS: NONE
OMB NO: 0920-0556 EXPIRATION DATE: 01/31/2006
RESPS:400 HOURS:63,400 COSTS(000):$1
Assisted Reproductive Technology (ART) Program Reporting System
FORMS: NONE
OMB NO: 0920-0557 EXPIRATION DATE: 07/31/2005
RESPS:20 HOURS:300 COSTS(000):$0
National Public Health Performance Standards Program State
Public Health Performance Assessment
FORMS: NONE
OMB NO: 0920-0558 EXPIRATION DATE: 08/31/2003
RESPS:1,870 HOURS:247 COSTS(000):$0
Development and Testing of a Tool to Assess the Pubic's
Perception About People with Epilepsy
FORMS: NONE
OMB NO: 0920-0559 EXPIRATION DATE: 08/31/2003
RESPS:416 HOURS:416 COSTS(000):$0
Dissemination of Lessons Learned from the Community Coalition
Partnership Programs for the Prevention of Teen Pregnancy
FORMS: NONE
OMB NO: 0920-0562 EXPIRATION DATE: 12/31/2003
RESPS:9,292 HOURS:6,969 COSTS(000):$0
National Suirvey of US Action Plan for Laboratory Containment of
Wild Polioviruses
FORMS: NONE
OMB NO: 0920-0563 EXPIRATION DATE: 11/30/2003
RESPS:11,050 HOURS:2,869 COSTS(000):$0
Survey to Assess Hepatitis B Vaccination Coverage Among U.S.
Health-Care Workers
FORMS: NONE
OMB NO: 0920-0564 EXPIRATION DATE: 09/30/2003
RESPS:5,000 HOURS:2,292 COSTS(000):$0
Joint Canadian US Survey of Health
FORMS: NONE
OMB NO: 0920-0565 EXPIRATION DATE: 10/31/2003
RESPS:1,200 HOURS:200 COSTS(000):$0
Reactions to Canadian Style Cigarette Warning Labels
FORMS: NONE
OMB NO: 0920-0566 EXPIRATION DATE: 10/31/2004
RESPS:8,000 HOURS:1,333 COSTS(000):$0
Evaluation of Worker Notification Program
FORMS: NONE
OMB NO: 0920-0567 EXPIRATION DATE: 10/31/2003
RESPS:268 HOURS:452 COSTS(000):$0
Evaluability Assessment of the Rape Prevention & Education Grant
Program
FORMS: NONE
OMB NO: 0920-0568 EXPIRATION DATE: 02/28/2005
RESPS:100 HOURS:100 COSTS(000):$0
Perceptions of Tuberculosis Among Foreign-Born Persons
FORMS: NONE
OMB NO: 0920-0569 EXPIRATION DATE: 11/30/2003
RESPS:4,000 HOURS:1,083 COSTS(000):$0
Anthropometric Survey of Respirator Users
FORMS: NONE
OMB NO: 0920-0570 EXPIRATION DATE: 12/31/2003
RESPS:2,010 HOURS:503 COSTS(000):$0
Hospital Bioterrorism Needs Assessment
FORMS: NONE
OMB NO: 0920-0571 EXPIRATION DATE: 04/30/2003
RESPS:273 HOURS:2,343 COSTS(000):$0
Minimum Data Elements (MDEs) System for Technical Assistance
Reporting (STAR) for the National Breast and Cervical Cancer
Early Detection Program (NBCCEDP)
FORMS: NONE
OMB NO: 0920-0572 EXPIRATION DATE: 01/31/2005
RESPS:7,018 HOURS:3,185 COSTS(000):$0
CDC and ATSDR Health Message Testing System and Smallpox
Knowledge Survey
FORMS: NONE
OMB NO: 0920-0573 EXPIRATION DATE: 11/30/2005
RESPS:79,981 HOURS:13,191 COSTS(000):$0
Adult and Pediatric Confidential HIV/AIDS Case Report
FORMS: CDC-50.42A CDC-50.42B
OMB NO: 0920-0574 EXPIRATION DATE: 12/31/2003
RESPS:12,000 HOURS:2,748 COSTS(000):$0
Impact of Community Coordinated Responses for the Prevention of
Intimate Partner Violence: A Random Digit Dial Survey
FORMS: NONE
OMB NO: 0920-0575 EXPIRATION DATE: 06/30/2003
RESPS:1,600 HOURS:533 COSTS(000):$0
Survey of Work-Relaed Assaults Treated in Hospital Emergency
Departments
FORMS: NONE
OMB NO: 0920-0576 EXPIRATION DATE: 08/31/2003
RESPS:15,853 HOURS:35,204 COSTS(000):$0
Possession, Use, and Transfer of Select Agents and Toxins (42
CFR Part 73)
FORMS: NONE
OMB NO: 0920-0577 EXPIRATION DATE: 02/29/2004
RESPS:3,698 HOURS:617 COSTS(000):$0
A and B Reader Surveys
FORMS: NONE
OMB NO: 0920-0578 EXPIRATION DATE: 01/31/2004
RESPS:53 HOURS:27 COSTS(000):$0
State Influenza Surveillance Activities Survey
FORMS: NONE
OMB NO: 0920-0580 EXPIRATION DATE: 02/28/2006
RESPS:1,067 HOURS:6,402 COSTS(000):$0
National Public Health Performance Standards Program Local
Public Health Governance Performance Assessment Tool
FORMS: NONE
OMB NO: 0920-0581 EXPIRATION DATE: 09/30/2004
RESPS:655 HOURS:185 COSTS(000):$0
Evaluation of the ACT Against Violence Training Program
FORMS: NONE
OMB NO: 0920-0582 EXPIRATION DATE: 01/31/2004
RESPS:36,246 HOURS:2,285 COSTS(000):$0
YMC Tracking Study
FORMS: NONE
OMB NO: 0920-0583 EXPIRATION DATE: 03/31/2004
RESPS:5,581 HOURS:485 COSTS(000):$0
YMC Tween Event Follow-up Study
FORMS: NONE
OMB NO: 0920-0584 EXPIRATION DATE: 03/31/2006
RESPS:60,750 HOURS:4,367 COSTS(000):$0
Population-based Research in Attention-Deficit/Hyperactivity
Disorder
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
119 1,842,424 926,468 $112
Agency for Toxic Substances and Disease Registry
OMB NO: 0923-0002 EXPIRATION DATE: 08/31/2003
RESPS:36 HOURS:18 COSTS(000):$0
Information Collection Procedures for Requesting Public Health
Assessments
FORMS: NONE
OMB NO: 0923-0006 EXPIRATION DATE: 10/31/2004
RESPS:6,927 HOURS:3,053 COSTS(000):$0
National Exposure Registry
FORMS: NONE
OMB NO: 0923-0007 EXPIRATION DATE: 09/30/2004
RESPS:150 HOURS:25 COSTS(000):$0
Community Assistance Panels Nomination Form
FORMS: NONE
OMB NO: 0923-0008 EXPIRATION DATE: 11/30/2004
RESPS:9,808 HOURS:7,356 COSTS(000):$0
Hazardous Substances Emergency Events Surveillance
FORMS: NONE
OMB NO: 0923-0016 EXPIRATION DATE: 01/31/2006
RESPS:1,140 HOURS:285 COSTS(000):$0
Reader Evaluation of Public Health Assessments and other Products
FORMS: NONE
OMB NO: 0923-0023 EXPIRATION DATE: 04/30/2003
RESPS:4,334 HOURS:1,083 COSTS(000):$0
Exposure to Volatile Organic Compounds and Childhood Leukemia
Incidence at United States Marine Corps Base Camp Lejeune, North
Carolina
FORMS: NONE
OMB NO: 0923-0030 EXPIRATION DATE: 12/31/2003
RESPS:6,667 HOURS:2,222 COSTS(000):$0
ATSDR Market Survey of Priority Populations
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
7 29,062 14,042 $0
National Institutes of Health
OMB NO: 0925-0001 EXPIRATION DATE: 05/31/2004
RESPS:114,407 HOURS:1,376,468 COSTS(000):$480
Research and Research Training Grant Applications and Related
Forms
FORMS: PHS-398 PHS-2590 PHS-2271 PHS-3734 HHS-568
OMB NO: 0925-0002 EXPIRATION DATE: 06/30/2005
RESPS:32,228 HOURS:85,679 COSTS(000):$148
Individual National Research Service Award Applications and
Related Forms
FORMS: 416-5 416-7 416-9 6031 6031-1 PHS-416-1
OMB NO: 0925-0046 EXPIRATION DATE: 08/31/2003
RESPS:13,780 HOURS:2,010 COSTS(000):$0
Pretesting of Office of Cancer Communications Messages
FORMS: NONE
OMB NO: 0925-0177 EXPIRATION DATE: 07/31/2005
RESPS:1,630 HOURS:163 COSTS(000):$0
Special Volunteer and Guest Researcher Assignment
FORMS: NIH-590
OMB NO: 0925-0208 EXPIRATION DATE: 10/31/2003
RESPS:1 HOURS:2,783 COSTS(000):$0
NCI Cancer Information Service Demographic/Customer Service Data
Collection
FORMS: NONE
OMB NO: 0925-0216 EXPIRATION DATE: 08/31/2004
RESPS:10,717 HOURS:8,639 COSTS(000):$0
The Framingham Study
FORMS: NONE
OMB NO: 0925-0240 EXPIRATION DATE: 04/30/2004
RESPS:9 HOURS:2,516 COSTS(000):$0
Drug Accountability Record
FORMS: NIH-2564 NIH-2564-1
OMB NO: 0925-0281 EXPIRATION DATE: 02/29/2004
RESPS:15,113 HOURS:3,746 COSTS(000):$0
The Atherosclerosis Risk in communities Study (ARIC)
FORMS: NONE
OMB NO: 0925-0299 EXPIRATION DATE: 02/28/2006
RESPS:21,545 HOURS:11,369 COSTS(000):$0
NIH Intramural Research Training Award Program Application
FORMS: NONE
OMB NO: 0925-0334 EXPIRATION DATE: 04/30/2004
RESPS:6,992 HOURS:1,719 COSTS(000):$0
The Cardiovascular Health Study
FORMS: NONE
OMB NO: 0925-0348 EXPIRATION DATE: 02/28/2005
RESPS:2 HOURS:360 COSTS(000):$0
Hazardous Waste Worker Training - 42 CFR Part 65
FORMS: NONE
OMB NO: 0925-0361 EXPIRATION DATE: 12/31/2004
RESPS:8,045 HOURS:12,611 COSTS(000):$0
National Institutes of Health Loan Repayment Programs
FORMS: NIH-2674-1 NIH-2674-2 NIH-2674-3 NIH-2674-4 NIH-2674-5
NIH-2674-6 NIH-2674-7 NIH-2674-8 NIH-2674-9 NIH-2674-10--12
OMB NO: 0925-0368 EXPIRATION DATE: 01/31/2004
RESPS:265,000 HOURS:30,979 COSTS(000):$0
Tobacco Use Supplement to the Current Population Survey: 2003
Tobacco Use Special Cessation Supplement to CPS
FORMS: NONE
OMB NO: 0925-0378 EXPIRATION DATE: 06/30/2004
RESPS:200 HOURS:125 COSTS(000):$0
Application for the Pharmacology Research Associate Program
FORMS: NIH-2721-1 NIH-2721-2
OMB NO: 0925-0406 EXPIRATION DATE: 11/30/2003
RESPS:25,012 HOURS:13,433 COSTS(000):$0
Agricultural health Study (A Prospective Cohort Study of Cancer
and Other Diseases Among Men and Women in Agriculture) -
Validation Sub-Study on Rheumatoid Arthritis
FORMS: NONE
OMB NO: 0925-0407 EXPIRATION DATE: 07/31/2005
RESPS:1 HOURS:39,597 COSTS(000):$0
Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening
Trial
FORMS: NONE
OMB NO: 0925-0414 EXPIRATION DATE: 05/31/2003
RESPS:85,011 HOURS:36,467 COSTS(000):$0
Women's Health Initiative Observational Study
FORMS: NONE
OMB NO: 0925-0417 EXPIRATION DATE: 08/31/2005
RESPS:42,800 HOURS:232,080 COSTS(000):$4
Responsibility of Applicants for Promoting Objectivity in
Research for Which Public Health Service Funding is Sought and
Responsible Prospective Contractors--42 CFR Part 50,....
FORMS: NONE
OMB NO: 0925-0423 EXPIRATION DATE: 12/31/2003
RESPS:150,166 HOURS:55,977 COSTS(000):$0
A Prospective Study of Diet and Cancer in Members of the
American Association of Retired Persons (AARP)
FORMS: NONE
OMB NO: 0925-0424 EXPIRATION DATE: 03/31/2005
RESPS:16,481 HOURS:16,481 COSTS(000):$0
National Institutes of Health Construction Grants - 42 CFR Part
52b (Final Rule)
FORMS: NONE
OMB NO: 0925-0438 EXPIRATION DATE: 07/31/2004
RESPS:1,330 HOURS:1,727 COSTS(000):$0
National Institutes of Health Undergraduate Scholarship Program
for Individuals from Disadvantaged Backgrounds
FORMS: NIH-2762-1 NIH-2762-2 NIH-2762-3 NIH-2762-4 NIH-2762-5
OMB NO: 0925-0449 EXPIRATION DATE: 10/31/2003
RESPS:600 HOURS:2,250 COSTS(000):$0
Alcoholism Prevalence and Gene/Environment Interactions in
American Indian Tribes, 10 Tribe Study
FORMS: NONE
OMB NO: 0925-0454 EXPIRATION DATE: 07/31/2004
RESPS:590 HOURS:216 COSTS(000):$0
Case-Cohort Study of Cancer and Related Disorders Among
Benzene-Exposed Workers in China
FORMS: NONE
OMB NO: 0925-0458 EXPIRATION DATE: 03/31/2004
RESPS:5,604 HOURS:1,776 COSTS(000):$0
Generic Clearance for Satisfaction Surveys of Customers and
Other Partners
FORMS: NONE
OMB NO: 0925-0466 EXPIRATION DATE: 04/30/2004
RESPS:14,390 HOURS:7,774 COSTS(000):$0
Evaluation of the National Youth Anti-Drug Media Campaign
(NYAMC): Revision
FORMS: NONE
OMB NO: 0925-0467 EXPIRATION DATE: 09/30/2005
RESPS:15,728 HOURS:7,864 COSTS(000):$0
Young Drivers Intervention Study
FORMS: NONE
OMB NO: 0925-0475 EXPIRATION DATE: 03/31/2005
RESPS:87 HOURS:40 COSTS(000):$0
Training Tomorrow's Scientists: Linking Minorities and Mentors
Through the Web
FORMS: NONE
OMB NO: 0925-0476 EXPIRATION DATE: 04/30/2003
RESPS:18,400 HOURS:2,263 COSTS(000):$0
Request for Generic Clearance to Conduct Voluntary
Customer/Partner Surveys
FORMS: NONE
OMB NO: 0925-0478 EXPIRATION DATE: 06/30/2003
RESPS:55,000 HOURS:11,962 COSTS(000):$0
2000 California Health Interview Survey, Cancer Control Tropical
Module (CHIS, CCTM)
FORMS: NONE
OMB NO: 0925-0479 EXPIRATION DATE: 06/30/2003
RESPS:62 HOURS:16 COSTS(000):$0
Request for Clearance to Conduct Voluntary Customer Satisfaction
Surveys
FORMS: NONE
OMB NO: 0925-0480 EXPIRATION DATE: 07/31/2003
RESPS:12,000 HOURS:2,000 COSTS(000):$0
NIDDK Information Clearinghouses Customer Satisfaction Survey
FORMS: NONE
OMB NO: 0925-0482 EXPIRATION DATE: 02/29/2004
RESPS:5,277 HOURS:1,867 COSTS(000):$0
The Family Health Study (Validation of a Family History of
Cancer Questionnaire for Risk Factor Surveillance)
FORMS: NONE
OMB NO: 0925-0483 EXPIRATION DATE: 03/31/2006
RESPS:1,233 HOURS:205 COSTS(000):$0
Environmental Factors in the Development of Polycystic Ovary
Syndrome
FORMS: NONE
OMB NO: 0925-0484 EXPIRATION DATE: 03/31/2004
RESPS:48,000 HOURS:48,000 COSTS(000):$0
National Epidemiologic Survey on Alcohol and Related Conditions
FORMS: N/A
OMB NO: 0925-0486 EXPIRATION DATE: 04/30/2004
RESPS:104,000 HOURS:8,684 COSTS(000):$0
Evaluation of User Satisfaction with NIH Internet Sites
FORMS: NONE
OMB NO: 0925-0488 EXPIRATION DATE: 05/31/2003
RESPS:400 HOURS:233 COSTS(000):$0
Survey of IRB Chairs Concerning the Implementatin of Pediatric
Research Regulation
FORMS: NONE
OMB NO: 0925-0489 EXPIRATION DATE: 06/30/2004
RESPS:200 HOURS:100 COSTS(000):$0
Customer/Partner Satisfaction Survey of the NIDCD Minority and
Disability Supplement Program
FORMS: NONE
OMB NO: 0925-0491 EXPIRATION DATE: 07/31/2004
RESPS:480 HOURS:160 COSTS(000):$0
The Jackson Heart Study: Annual Follow-up with Third Party
Respondents
FORMS: NONE
OMB NO: 0925-0492 EXPIRATION DATE: 10/31/2003
RESPS:1 HOURS:60 COSTS(000):$0
Validation of Questionnaires Used for Occupational Exposure
Assessment in Case-Control Studies: Occupational History
Questionnaire with Foundry Worker & Textile Industry Job Modules
FORMS: NONE
OMB NO: 0925-0493 EXPIRATION DATE: 09/30/2004
RESPS:555 HOURS:42 COSTS(000):$0
Multi-Ethnic Study of Atherosclerosis (MESA) Event Surveillance
FORMS: NONE
OMB NO: 0925-0494 EXPIRATION DATE: 10/31/2003
RESPS:340 HOURS:340 COSTS(000):$0
A Nested Case-Control Study of Lung Cancer and Diesel Exhaust
Among Non-Metal Miners
FORMS: NONE
OMB NO: 0925-0495 EXPIRATION DATE: 10/31/2004
RESPS:700 HOURS:400 COSTS(000):$0
Leukemia and Other Hematological Diseases Among Cleanup Workers
in Ukraine Following the Chornobyl Accident
FORMS: NONE
OMB NO: 0925-0496 EXPIRATION DATE: 10/31/2003
RESPS:6,223 HOURS:1,556 COSTS(000):$0
Extended Lung Cancer Incidence Follow-Up for the Mayo Lung
Project Participants (MLP-EI)
FORMS: NONE
OMB NO: 0925-0498 EXPIRATION DATE: 04/30/2005
RESPS:520 HOURS:520 COSTS(000):$0
Study of Testicular Germ Cell Cancer in U.S. Military
Servicemen: Sub-study of Maternal Risk Factors
FORMS: NONE
OMB NO: 0925-0499 EXPIRATION DATE: 04/30/2003
RESPS:1,000 HOURS:500 COSTS(000):$0
The National Survey to Evaluate the NIH SBIR Program
FORMS: NONE
OMB NO: 0925-0500 EXPIRATION DATE: 06/30/2005
RESPS:2,415 HOURS:746 COSTS(000):$0
National Cancer Institute Cancer Information Service Evaluation
Surveys
FORMS: NONE
OMB NO: 0925-0501 EXPIRATION DATE: 06/30/2005
RESPS:3,750 HOURS:1,313 COSTS(000):$0
Graduate Student Training Programs Application
FORMS: NONE
OMB NO: 0925-0502 EXPIRATION DATE: 05/31/2003
RESPS:448 HOURS:112 COSTS(000):$0
A Follow-up Survey of National Cancer Institute Science
Enrichment Program Students
FORMS: NONE
OMB NO: 0925-0503 EXPIRATION DATE: 06/30/2005
RESPS:300 HOURS:300 COSTS(000):$0
Assessment of the Use of Special Funding for Research on Type 1
Diabetes Provided by the Balanced Budget Act of 1997 and the FY
2001 Consolidated Appropriations Act
FORMS: NONE
OMB NO: 0925-0504 EXPIRATION DATE: 07/31/2003
RESPS:620 HOURS:318 COSTS(000):$0
Evaluation of the NCI State-of-the-Science Web Site
FORMS: NONE
OMB NO: 0925-0505 EXPIRATION DATE: 07/31/2003
RESPS:3,900 HOURS:1,287 COSTS(000):$0
Ethical Issues Associated with Nurse Practitioner and Physician
Assistant Practice:
FORMS: NONE
OMB NO: 0925-0506 EXPIRATION DATE: 10/31/2003
RESPS:50,000 HOURS:10,700 COSTS(000):$0
Retrovirus Epidemiology Donor Study (REDS): A Study of
Motivations and Deterrents to Blood Donation in the United States
FORMS: NONE
OMB NO: 0925-0507 EXPIRATION DATE: 08/31/2003
RESPS:11,350 HOURS:4,049 COSTS(000):$0
Health Information National Trends Survey (HINTS)
FORMS: NONE
OMB NO: 0925-0510 EXPIRATION DATE: 04/30/2003
RESPS:600 HOURS:300 COSTS(000):$0
An Evaluation of the National Cancer Institute Science
Enrichment Program
FORMS: NONE
OMB NO: 0925-0512 EXPIRATION DATE: 12/31/2005
RESPS:15,035 HOURS:1,593 COSTS(000):$0
Behavioral and Environmental Risk Factors for Childhood Drowning
FORMS: NONE
OMB NO: 0925-0513 EXPIRATION DATE: 10/31/2004
RESPS:7,000 HOURS:1,750 COSTS(000):$0
HIV Vaccine Awareness Study - Americans' Attitudes
FORMS: NONE
OMB NO: 0925-0514 EXPIRATION DATE: 10/31/2004
RESPS:8,000 HOURS:2,820 COSTS(000):$0
California Health Interview Survey - Complementary and
Alternative Medicine (CHIS-CAM)
FORMS: NONE
OMB NO: 0925-0515 EXPIRATION DATE: 01/31/2005
RESPS:2,600 HOURS:762 COSTS(000):$0
National Kidney Disease Education Program Evaluation Survey
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
58 1,207,878 2,059,807 $632
Substance Abuse and Mental Health Services Administration
OMB NO: 0930-0074 EXPIRATION DATE: 03/31/2004
RESPS:900 HOURS:176 COSTS(000):$0
Obligated Service for Mental Health Traineeships: Regulations
and Forms
FORMS: SMA-111 SMA-111-1 SMA-111-2
OMB NO: 0930-0078 EXPIRATION DATE: 12/31/2005
RESPS:679,716 HOURS:46,738 COSTS(000):$0
Drug Abuse Warning Network (DAWN)
FORMS: SMA-100-1 SMA-100-2 SMA-100-3 SMA-100-4
OMB NO: 0930-0080 EXPIRATION DATE: 07/31/2004
RESPS:60 HOURS:34,640 COSTS(000):$0
Substance Abuse Prevention and Treatment Block Grant Application
Format - FY2002-2004
FORMS: NONE
OMB NO: 0930-0092 EXPIRATION DATE: 07/31/2004
RESPS:1,485,000 HOURS:259,876 COSTS(000):$73
Confidentiality of Alcohol and Drug Abuse Patient Records - 42
CFR Part 2
FORMS: NONE
OMB NO: 0930-0093 EXPIRATION DATE: 10/31/2003
RESPS:52 HOURS:104 COSTS(000):$0
Annual Census of Patient Characteristics in State and County
Mental Hospital Inpatient Services
FORMS: SMA-102
OMB NO: 0930-0104 EXPIRATION DATE: 06/30/2004
RESPS:16 HOURS:7 COSTS(000):$0
Community Mental Health Centers Construction Grantee Checklist -
Form and Regulations
FORMS: SMA-101
OMB NO: 0930-0106 EXPIRATION DATE: 12/31/2005
RESPS:24,305 HOURS:14,158 COSTS(000):$0
Drug and Alcohol Services Information System (DASIS)
FORMS: NONE
OMB NO: 0930-0110 EXPIRATION DATE: 01/31/2004
RESPS:183,690 HOURS:84,188 COSTS(000):$0
2003 National Survey on Drug Use and Health
FORMS: NONE
OMB NO: 0930-0119 EXPIRATION DATE: 07/31/2005
RESPS:4,186 HOURS:4,093 COSTS(000):$0
2002 Survey of Mental Health Organizations, General Hospital
Mental Health Services, and Managed Care Organizations (SMHO)
FORMS: NONE
OMB NO: 0930-0158 EXPIRATION DATE: 06/30/2003
RESPS:7,093,210 HOURS:1,790,664 COSTS(000):$2,016
Mandatory guidelines for Federal Workplace Drug Testing Program
FORMS: NONE
OMB NO: 0930-0163 EXPIRATION DATE: 02/29/2004
RESPS:60 HOURS:961 COSTS(000):$0
Substance Abuse Prevention and Treatment Block Grant
Regulations- 45 CFR Part 96
FORMS: NONE
OMB NO: 0930-0168 EXPIRATION DATE: 07/31/2004
RESPS:59 HOURS:16,360 COSTS(000):$0
FY 2002-2004 Community Mental Health Services Block Grant
Application: Voluntary Format and Content
FORMS: NONE
OMB NO: 0930-0169 EXPIRATION DATE: 03/31/2004
RESPS:114 HOURS:2,166 COSTS(000):$0
Protection and Advocacy of Individuals with Mental Illness
(PAIMI) Annual Program Performance Report
FORMS: NONE
OMB NO: 0930-0172 EXPIRATION DATE: 02/29/2004
RESPS:136 HOURS:168 COSTS(000):$0
Protection and Advocacy Program for Individuals with Mental
Illness Regulations -- 45 CFR Part 51
FORMS: NONE
OMB NO: 0930-0192 EXPIRATION DATE: 12/31/2005
RESPS:11,255 HOURS:14,164 COSTS(000):$0
National Evaluation of the Comprehensive Community Mental Health
Services for Children and Their Families Program: Phase Two
FORMS: NONE
OMB NO: 0930-0195 EXPIRATION DATE: 09/30/2004
RESPS:12,901 HOURS:2,252 COSTS(000):$0
Participant Feedback for the Mental Health Care Provider
Education in HIV/AIDS Program II and III
FORMS: NONE
OMB NO: 0930-0197 EXPIRATION DATE: 12/31/2004
RESPS:30,150 HOURS:10,375 COSTS(000):$0
Voluntary Customer Satisfaction Surveys to Implement Executive
Order 12862 in the Substance Abuse and Mental Health Services
Administration (SAMHSA)
FORMS: NONE
OMB NO: 0930-0202 EXPIRATION DATE: 07/31/2003
RESPS:731 HOURS:1,171 COSTS(000):$0
Persistent Effects of Treatment Studies
FORMS: NONE
OMB NO: 0930-0203 EXPIRATION DATE: 04/30/2005
RESPS:10 HOURS:23 COSTS(000):$0
Assessment of the National Leadership Institute (NLI) Program
and Services and the Minority Community-based Organization
(MCBO) Program
FORMS: NONE
OMB NO: 0930-0205 EXPIRATION DATE: 01/31/2006
RESPS:454 HOURS:13,794 COSTS(000):$0
Annual Reports for Projects for Assistance in Transition from
Homelessness (PATH)
FORMS: NONE
OMB NO: 0930-0206 EXPIRATION DATE: 09/30/2003
RESPS:8,321 HOURS:1,944 COSTS(000):$1,796
Opiod Drugs in Maintenance and Detoxification Treatment of
Opiate Dependence - 42 CFR Part 8
FORMS: SMA-162 SMA-163 SMA-168
OMB NO: 0930-0208 EXPIRATION DATE: 12/31/2005
RESPS:139,793 HOURS:25,543 COSTS(000):$0
SAMHSA Government Performance and Results Act (GPRA) Client
Outcome Measures for Discretionary Programs
FORMS: NONE
OMB NO: 0930-0209 EXPIRATION DATE: 05/31/2003
RESPS:93,826 HOURS:20,046 COSTS(000):$0
National Evaluation of the Comprehensive Community Mental Health
Services for Children and Their Families Program: Phase Three
FORMS: NONE
OMB NO: 0930-0210 EXPIRATION DATE: 05/31/2003
RESPS:260 HOURS:315 COSTS(000):$0
Registration Form for the National Registry of Effective
Prevention Programs
FORMS: NONE
OMB NO: 0930-0213 EXPIRATION DATE: 06/30/2003
RESPS:24,525 HOURS:17,959 COSTS(000):$0
State Prevention Needs Assessment Surveys: Alcohol and
FORMS: NONE
OMB NO: 0930-0216 EXPIRATION DATE: 09/30/2003
RESPS:48,247 HOURS:6,393 COSTS(000):$0
National Cross-Site Assessment of Addiction Technology Transfer
Centers (ATTC) Network
FORMS: NONE
OMB NO: 0930-0217 EXPIRATION DATE: 01/31/2004
RESPS:10 HOURS:100 COSTS(000):$0
Administrative Reporting Form for the "Women, Co-occurring
Disorders and Violence Cooperative Agreement Program (Phase II)"
FORMS: NONE
OMB NO: 0930-0222 EXPIRATION DATE: 07/31/2004
RESPS:59 HOURS:1,947 COSTS(000):$0
Substance Abuse Prevention and Treatment Block Grant Synar
Report Format, FY 2002-2004
FORMS: NONE
OMB NO: 0930-0223 EXPIRATION DATE: 09/30/2004
RESPS:2,280 HOURS:2,503 COSTS(000):$0
Evaluation of the CMHS/CSAT Collaborative Program on Homeless
Families: Women with Psychiatric, Substance Use, or Co-occuring
Disorders and Their Dependent Children
FORMS: NONE
OMB NO: 0930-0226 EXPIRATION DATE: 07/31/2004
RESPS:313 HOURS:1,204 COSTS(000):$0
Protocols for the Cross-Site Process Evaluation of the State
FORMS: NONE
OMB NO: 0930-0229 EXPIRATION DATE: 04/30/2005
RESPS:6 HOURS:18 COSTS(000):$0
Emergency Response Grants - 42 CFR Part 51
FORMS: NONE
OMB NO: 0930-0230 EXPIRATION DATE: 01/31/2005
RESPS:404 HOURS:1,212 COSTS(000):$0
Core Measures for the Center for Substance Abuse Prevention
FORMS: NONE
OMB NO: 0930-0231 EXPIRATION DATE: 02/28/2005
RESPS:721 HOURS:577 COSTS(000):$0
National Survey on Drug Use and Health: Clinical Validation
Study of Substance Abuse and Dependence Measures
FORMS: NONE
OMB NO: 0930-0232 EXPIRATION DATE: 02/28/2005
RESPS:5,160 HOURS:1,210 COSTS(000):$0
Workplace Helpline Call Record Form and Technical Assistance
Follow-up Survey Form
FORMS: NONE
OMB NO: 0930-0233 EXPIRATION DATE: 05/31/2005
RESPS:2,022 HOURS:170 COSTS(000):$0
Mexican Border Youth Survey
FORMS: NONE
OMB NO: 0930-0234 EXPIRATION DATE: 12/31/2005
RESPS:1,233 HOURS:103 COSTS(000):$0
Notification of Intent to Use Schedule III, IV, or V Opioid
Drugs for the Maintenance and Detoxification Treatment of Opiate
Addiction under 21 USC / 823(g)(2)
FORMS: SMA-167
OMB NO: 0930-0235 EXPIRATION DATE: 06/30/2005
RESPS:905 HOURS:2,034 COSTS(000):$0
Methamphetamine Abuse Treatment - Special Studies
FORMS: NONE
OMB NO: 0930-0236 EXPIRATION DATE: 12/31/2003
RESPS:274 HOURS:224 COSTS(000):$0
An Assessment of the Status of PASRR and Mental Health Services
for Persons in Nursing Facilities
FORMS: NONE
OMB NO: 0930-0238 EXPIRATION DATE: 08/31/2004
RESPS:18,488 HOURS:6,878 COSTS(000):$0
State Treatment Needs Assessment Program (STNAP)
FORMS: NONE
OMB NO: 0930-0240 EXPIRATION DATE: 12/31/2005
RESPS:25,345 HOURS:7,141 COSTS(000):$0
Evaluation of the Center for Substance Abuse Prevention's
Underage Drinking Prevention Public Education Program
FORMS: NONE
OMB NO: 0930-0241 EXPIRATION DATE: 10/31/2005
RESPS:3,200 HOURS:2,804 COSTS(000):$0
Survey of the Characteristics and Funding of School Mental
Health Services
FORMS: NONE
OMB NO: 0930-0243 EXPIRATION DATE: 03/31/2006
RESPS:3,240 HOURS:1,080 COSTS(000):$0
Prevention Program Outcomes Monitoring System
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
42 9,905,637 2,397,483 $3,885
Agency for Health Care Policy and Research
OMB NO: 0935-0104 EXPIRATION DATE: 03/31/2004
RESPS:52,306 HOURS:49,105 COSTS(000):$0
Medical Expenditure Panel Survey Household Component (MEPS-HC) -
2001 through 2004
FORMS: NONE
OMB NO: 0935-0106 EXPIRATION DATE: 09/30/2004
RESPS:112,800 HOURS:20,667 COSTS(000):$515,732
Voluntary Customer Satisfaction Survey Generic Clearance for
FORMS: NONE
OMB NO: 0935-0108 EXPIRATION DATE: 02/28/2005
RESPS:53,660 HOURS:23,216 COSTS(000):$0
Medical Expenditure Panel Survey Medical Provider Component
(MEPS-MPC) for 2001 and 2002
FORMS: NONE
OMB NO: 0935-0110 EXPIRATION DATE: 02/28/2005
RESPS:35,131 HOURS:21,191 COSTS(000):$0
2001-2003 Medical Expenditure Panel Survey-Insurance Component
(MEPS-IC)
FORMS: NONE
OMB NO: 0935-0113 EXPIRATION DATE: 08/31/2003
RESPS:1,125 HOURS:281 COSTS(000):$35,000
Enrolle Survey of Relationship Between Out-of-Pocket Costs and
Use of Prescribed Medications
FORMS: NONE
OMB NO: 0935-0114 EXPIRATION DATE: 01/31/2004
RESPS:280 HOURS:124 COSTS(000):$50,000
Pilot Study of Hospital Adverse Event Reporting Survey
FORMS: NONE
OMB NO: 0935-0115 EXPIRATION DATE: 01/31/2004
RESPS:900 HOURS:300 COSTS(000):$50,000
Pilot Data for the Development of Hospital Patient Safety
Culture Survey
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
7 256,202 114,884 $650,732
Office of Assistant Secretary for Health
OMB NO: 0937-0025 EXPIRATION DATE: 07/31/2003
RESPS:10,000 HOURS:4,000 COSTS(000):$0
Application for Appointment as a Commissioned Officer in U.S.
Public Health Service Commissioned Corps (and) Reference Request
for Applicants to the USPHS Commissioned Corps
FORMS: PHS-50 PHS-1813
OMB NO: 0937-0095 EXPIRATION DATE: 09/30/2005
RESPS:10 HOURS:40 COSTS(000):$0
Application to the Board of Correction of Public Health Service
Commissioned Corps Records
FORMS: PSC-54
OMB NO: 0937-0166 EXPIRATION DATE: 05/31/2003
RESPS:50,000 HOURS:50,000 COSTS(000):$0
42 CFR Part B: Sterilization of Persons in Federally Assisted
Family Planning Projects
FORMS: NONE
OMB NO: 0937-0191 EXPIRATION DATE: 07/31/2004
RESPS:32 HOURS:6,400 COSTS(000):$226
Application Packets for Real Property for Public Health Purposes
FORMS: HHS-696
OMB NO: 0937-0198 EXPIRATION DATE: 01/31/2006
RESPS:3,300 HOURS:3,721 COSTS(000):$0
Responsibilities of Awardees and Applicant Institutions for
Reporting Possible Misconduct in Science (42 CFR Part 50)
FORMS: PHS-6349
OMB NO: 0937-0200 EXPIRATION DATE: 02/29/2004
RESPS:61,300 HOURS:184,200 COSTS(000):$0
HHS Payment Management System Forms
FORMS: SF-270 SF-272
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
6 124,642 248,361 $226
Centers for Medicare and Medicaid Services
OMB NO: 0938-0008 EXPIRATION DATE: 03/31/2006
RESPS:740,215,135 HOURS:44,189,007 COSTS(000):$0
Health Insurance Common Claims Formand Supporting Regulations:
42 CFR 414.40, 424.32, 424.44
FORMS: CMS-1490S CMS-1490U CMS-1500
OMB NO: 0938-0022 EXPIRATION DATE: 05/31/2004
RESPS:7,310 HOURS:1,311,060 COSTS(000):$0
Home Health Agency Cost Report and Supporting Regulations in 42
CFR 413.20, 413.24, 413.106
FORMS: HCFA-1728-94
OMB NO: 0938-0023 EXPIRATION DATE: 07/31/2005
RESPS:2,000 HOURS:500 COSTS(000):$0
Attending Physicians Statement and Documentation of Medicare
Emergency and Supporting Regulations in 42 CFR, Section 424.103
FORMS: CMS-1771
OMB NO: 0938-0025 EXPIRATION DATE: 10/31/2003
RESPS:14,000 HOURS:5,833 COSTS(000):$0
Request for Termination of Premium-Hospital and/or Supplementary
Medical Insurance and Supporting Regulations in 42 CFR 406.28
and 407.27
FORMS: HCFA-1763
OMB NO: 0938-0027 EXPIRATION DATE: 09/30/2005
RESPS:98 HOURS:172 COSTS(000):$0
The Request for Certification as a Supplier of Portable X-Ray
and Portable X-Ray Survey Report form under the
Medicare/Medicaid Program - Portable X-Ray Survey Report &
Supporting Regulations..
FORMS: CMS-1880 CMS-1882
OMB NO: 0938-0034 EXPIRATION DATE: 10/31/2003
RESPS:55,000 HOURS:9,167 COSTS(000):$0
Request for Hearing for Part B Medicare Claim and Supporting
Regulations in 42 CFR, 405.821
FORMS: HCFA-1965
OMB NO: 0938-0035 EXPIRATION DATE: 06/30/2003
RESPS:2,000 HOURS:716 COSTS(000):$0
SSO Report of State Buy-in Problems, 42 CFR 407.40
FORMS: HCFA-1957
OMB NO: 0938-0037 EXPIRATION DATE: 02/28/2005
RESPS:716 HOURS:71,600 COSTS(000):$0
Outpatient Rehabilitation Cost Report and Supporting Regulations
in 42 CFR 413.20 and 413.24
FORMS: CMS-2088-92
OMB NO: 0938-0041 EXPIRATION DATE: 10/31/2003
RESPS:15,000 HOURS:6,250 COSTS(000):$0
Third Party Premium Billing Request and Supporting Regulations
in 42 CFR 408.6
FORMS: HCFA-2384
OMB NO: 0938-0042 EXPIRATION DATE: 03/31/2004
RESPS:9,301,183 HOURS:390,418 COSTS(000):$0
Request for Medicare Payment - Ambulance and Supporting
Regulations in 42 CFR Section 410.40 and 424.124
FORMS: HCFA-1491
OMB NO: 0938-0045 EXPIRATION DATE: 10/31/2003
RESPS:62,000 HOURS:15,500 COSTS(000):$0
Request for Reconsideration of Part A Medicare Claim and
Supporting Regulations in 42 CFR, 405.711
FORMS: HCFA-2649
OMB NO: 0938-0046 EXPIRATION DATE: 08/31/2004
RESPS:60,000 HOURS:25,000 COSTS(000):$0
End Stage Renal Disease Medical Evidence Report Medicare
Entitlement and/or Patient Registration and Supporting
Regulations in 42 CFR, 405.2133
FORMS: HCFA-2728(ESRD)
OMB NO: 0938-0050 EXPIRATION DATE: 11/30/2005
RESPS:6,010 HOURS:3,980,522 COSTS(000):$0
Hospital and Health Care Complexes Cost Report and Supporting
Regulations in 42 CFR 413.20 and 413.24
FORMS: CMS-2552-96
OMB NO: 0938-0062 EXPIRATION DATE: 11/30/2003
RESPS:6,763 HOURS:20,289 COSTS(000):$0
Intermediate Care Facility for the Mentally Retarded or Persons
with Related Conditions ICF/MR Survey Report Form (3070G-1) and
Suppporting Regulations at 42CFR 431.52, 431.151, 435.1009,....
FORMS: HCFA-3070-G-1
OMB NO: 0938-0065 EXPIRATION DATE: 10/31/2005
RESPS:255 HOURS:446 COSTS(000):$0
Request for Certification in the Medicare and/or Medicaid
Program to Provide Outpatient Physical Therapy and/or Speech
Pathology Services, Outpatient Physical Therapy Speech......
FORMS: CMS-1856 CMS-1893
OMB NO: 0938-0067 EXPIRATION DATE: 04/30/2005
RESPS:224 HOURS:18,144 COSTS(000):$0
Quarterly Medicaid Statement of Expenditures for the Medical
Assistance Program
FORMS: HCFA-64
OMB NO: 0938-0074 EXPIRATION DATE: 12/31/2005
RESPS:661 HOURS:1,157 COSTS(000):$0
Request for Certification as Rural Health Clinic and Rural
Health Clinic Survey Report Form and Supporting Regulations in
42 CFR 491.1-491.11
FORMS: CMS-0029/0030
OMB NO: 0938-0080 EXPIRATION DATE: 07/31/2003
RESPS:90,000 HOURS:26,000 COSTS(000):$0
Application for Health Insurance Benefits Under Medicare for
Individual with Chronic Renal Disease and Supporting Regulations
in 42 CFR 406.13
FORMS: HCFA-43
OMB NO: 0938-0086 EXPIRATION DATE: 10/31/2005
RESPS:125,000 HOURS:62,500 COSTS(000):$0
Disclosure of Ownership and Financial Control Interest Statement
and Supporting Regulations Contained in 42 CFR 420.200-.206 and
455.100-.106
FORMS: CMS-1513
OMB NO: 0938-0101 EXPIRATION DATE: 07/31/2005
RESPS:224 HOURS:8,064 COSTS(000):$0
Medicaid Program Budget Report
FORMS: CMS-37 (HCFA-37)
OMB NO: 0938-0102 EXPIRATION DATE: 10/31/2003
RESPS:108 HOURS:4,860 COSTS(000):$0
Organ Procurement Organization/Histcompatibility Laboratory
Statement of Reimbursable Costs, Manual Instructions and
Supporting Regulations Contained in 42 CFR 413.20 and 413.24
FORMS: HCFA-216
OMB NO: 0938-0107 EXPIRATION DATE: 10/31/2005
RESPS:3,000 HOURS:150,000 COSTS(000):$0
Independent Rural Health Center/Freestanding Federally Qualified
Health Center Cost Report and Supporting Regulations in 42 CFR
Sections 413.20 and 413.24
FORMS: CMS-222-92
OMB NO: 0938-0146 EXPIRATION DATE: 12/31/2005
RESPS:110 HOURS:2,640 COSTS(000):$0
State Medicaid Eligibility Quality Control Samplling Plan and
Supporting Regulations in 42 CFR 431.800 - 431.865
FORMS: CMS-317
OMB NO: 0938-0147 EXPIRATION DATE: 12/31/2005
RESPS:12 HOURS:5,280 COSTS(000):$0
State Medicaid Eligibility Control (MEQC) Sample Selection Lists
and Supporting Regulations at 42 CFR 431.800 431.865
FORMS: CMS-319
OMB NO: 0938-0151 EXPIRATION DATE: 04/30/2003
RESPS:13,250 HOURS:6,625 COSTS(000):$0
Laboratory Personnel Report (CLIA) and Supporting Regulations in
42 CFR 493.1-493.2001
FORMS: HCFA-0209
OMB NO: 0938-0155 EXPIRATION DATE: 12/31/2003
RESPS:14 HOURS:476 COSTS(000):$0
Municipal Health Services Cost Report Form and Supporting
Regulations 42 CFR 405.2470
FORMS: HCFA-255
OMB NO: 0938-0165 EXPIRATION DATE: 03/31/2006
RESPS:225 HOURS:7,860 COSTS(000):$0
Prepaid Health Plan Cost Report
FORMS: CMS-276
OMB NO: 0938-0170 EXPIRATION DATE: 09/30/2005
RESPS:1,363 HOURS:682 COSTS(000):$0
Blood Bank Inspection Checklist and Report and Supporting
Regulations in 42 CFR 493.1269-493-1285
FORMS: CMS-282
OMB NO: 0938-0193 EXPIRATION DATE: 05/31/2004
RESPS:56 HOURS:560 COSTS(000):$0
Transmittal and Notice of Approval of State Plan Material and
Supporting Regulations in 42 CFR 430.10-430.20 and 440.167
FORMS: HCFA-179
OMB NO: 0938-0202 EXPIRATION DATE: 06/30/2005
RESPS:1,231 HOURS:573,646 COSTS(000):$0
Home Office Cost Statement and Supporting Regulations in 42 CFR
413.17 and 413.20
FORMS: CMS-287-92
OMB NO: 0938-0214 EXPIRATION DATE: 05/31/2004
RESPS:867,863,540 HOURS:1,339,982 COSTS(000):$0
Medicare Secondary Payer Information Collection and Supporting
Regulations in 42 CFR 411.25, 489.2, and 489.20
FORMS: CMS-250-254
OMB NO: 0938-0236 EXPIRATION DATE: 08/31/2004
RESPS:3,085 HOURS:604,660 COSTS(000):$0
Independent Renal Dialysis Facility Cost Report and Supporting
Regulations 42 CFR 413.20 and 42 CFR 413.24
FORMS: HCFA-265
OMB NO: 0938-0242 EXPIRATION DATE: 07/31/2003
RESPS:27,900 HOURS:25,000 COSTS(000):$0
Fire Safety Survey Report Forms and supporting regulations in 42
CFR 416.44, 418.100, 482.41, 483.270, and 483.470
FORMS: CMS-2786-A-D 2786-F 2786-G 2786-H 2786-J 2786-K 2786-L 2786-M
2786-P 2786-Q
OMB NO: 0938-0245 EXPIRATION DATE: 04/30/2003
RESPS:10,000 HOURS:2,500 COSTS(000):$0
Request for Enrollment in Supplementary Medical Insurance and
Supporting Regulations in 42 CFR 407.10 & 407.11
FORMS: HCFA-4040
OMB NO: 0938-0251 EXPIRATION DATE: 09/30/2004
RESPS:50,000 HOURS:12,500 COSTS(000):$0
Application for Hospital Insurance in 42 CFR 406.7
FORMS: HCFA-18F5
OMB NO: 0938-0266 EXPIRATION DATE: 04/30/2003
RESPS:2,931 HOURS:1,434 COSTS(000):$0
Ambulatory Surgical Center Request for Certification and Survey
Report and Supporting Regulations in 42 CFR 416.1-416.150
FORMS: HCFA-377 HCFA-378 HCFA-R-54
OMB NO: 0938-0267 EXPIRATION DATE: 04/30/2003
RESPS:540 HOURS:260,848 COSTS(000):$0
Comprehensive Outpatient Rehabilitation Facility (CORF)
Eligibility and Survey Forms and Information Collection
Requirements at 42 CFR 485.56, 485.58, 485.60, 485.64....
FORMS: HCFA-359 360 R-55
OMB NO: 0938-0269 EXPIRATION DATE: 12/31/2005
RESPS:750 HOURS:375 COSTS(000):$0
Request for Accelerated Payments and Supporting Regulations in
42 CFR, section 412.116, 412.632, 413.64, 413.350, and 484.245
FORMS: CMS-9042
OMB NO: 0938-0270 EXPIRATION DATE: 09/30/2004
RESPS:500 HOURS:1,000 COSTS(000):$0
The Financial Statement of Debtor and Supporting Regulations in
42 CFR, Section 405.376
FORMS: HCFA-379
OMB NO: 0938-0272 EXPIRATION DATE: 10/31/2003
RESPS:243 HOURS:18,225 COSTS(000):$0
Annual Report on Home and Community-Based Services Waivers and
Supporting Regulations in 42 CFR 440.181 and 441.300-305, Forms
HCFA-372 and HCFA-372(S)
FORMS: HCFA-372 HCFA-372(S)
OMB NO: 0938-0273 EXPIRATION DATE: 10/31/2005
RESPS:2,833 HOURS:708 COSTS(000):$0
Identification of Extension Units of Outpatient Physical
Therapy/Outpatient Speech Pathology (OPT/OSP) Providers and
Supporting Regulations in 42 CFR Sections 485.701 - 485.729
FORMS: CMS-381
OMB NO: 0938-0279 EXPIRATION DATE: 04/30/2003
RESPS:158,603,290 HOURS:1,960,991 COSTS(000):$0
Medicare Uniform Institutional Provider Bill and Supporting
Regulatins in 42 CFR 424.5
FORMS: HCFA-1450
OMB NO: 0938-0287 EXPIRATION DATE: 12/31/2005
RESPS:27 HOURS:81 COSTS(000):$0
Withholding Medicare Payments to Recover Medicaid Overpayments
and Supporting Regulations in 42 CFR 447.31
FORMS: HCFA-R-0021
OMB NO: 0938-0296 EXPIRATION DATE: 04/30/2004
RESPS:291 HOURS:14,000 COSTS(000):$0
Provider Reimbursement Manual, Part 1-Chapter 27, Sections 2721,
2722 & 2725, Request for Exception to End Stage Renal Disease
Composite Rates & Supporting Regulations in 42 CFR 413.170......
FORMS: HCFA-9044
OMB NO: 0938-0300 EXPIRATION DATE: 10/31/2004
RESPS:51 HOURS:6,891 COSTS(000):$0
Quality Control of Negative Case Actions (NCA)
FORMS: CMS-6401
OMB NO: 0938-0301 EXPIRATION DATE: 11/30/2005
RESPS:30,526 HOURS:900,517 COSTS(000):$0
Medicare Provider Cost Report Reimbursement Questionnaire and
Supporting Regulations 42 CFRE 413.20, 413.24
FORMS: CMS-339
OMB NO: 0938-0313 EXPIRATION DATE: 08/31/2004
RESPS:2,286 HOURS:572 COSTS(000):$0
Hospice Request for Certification in the Medicare Program and
Supporting Regulations Contained in 42 CFR Part 418.1-418.405
FORMS: HCFA-417
OMB NO: 0938-0328 EXPIRATION DATE: 04/30/2003
RESPS:1,500 HOURS:53,163 COSTS(000):$0
Hospital COP-42 CFR 482, 482.12, 482.22, 482.27, 482.30, 482.62,
482.66
FORMS: HCFA-R-48
OMB NO: 0938-0334 EXPIRATION DATE: 04/30/2003
RESPS:3,528 HOURS:9,744 COSTS(000):$0
Conditions of Participation for Rural Health Clinics and
Supporting Regulations in 42 CFR, Section 491.9, Subpart A
FORMS: HCFA-R-38
OMB NO: 0938-0338 EXPIRATION DATE: 09/30/2005
RESPS:645 HOURS:1,612 COSTS(000):$0
Conditions of Participation for Portable X-ray Supliers and
Supporting Regulations in 42 CFR Sections 486.104, 486.106, and
406.110
FORMS: CMS-R-43
OMB NO: 0938-0345 EXPIRATION DATE: 09/30/2005
RESPS:212 HOURS:2,120 COSTS(000):$45
Medicaid Statistical Information System
FORMS: CMS-R-0284
OMB NO: 0938-0354 EXPIRATION DATE: 11/30/2005
RESPS:56 HOURS:1,568 COSTS(000):$15
Annual Early and Periodic Screening, Diagnostic and Treatment
Services (EPSDT) Participation Report
FORMS: CMS-416
OMB NO: 0938-0355 EXPIRATION DATE: 09/30/2003
RESPS:13,994 HOURS:19,884 COSTS(000):$0
Home Health Agency survey and Deficiencies Report, Home Health
Functional Assessment Instrument and Supporting Regulations in
42 CFR Part 484.10 - 42 CFR Part 484.52
FORMS: HCFA-1572 HCFA-1515
OMB NO: 0938-0357 EXPIRATION DATE: 11/30/2005
RESPS:4,750,000 HOURS:1,583,333 COSTS(000):$0
Home Health Services Under Hospital Insurance, Manual
Instructions and Supporting Regulations in 42 CFR 409.40 - 50,
410.36, 410.170, 411.4-.15, 421.100, 424.22, 484.18 and 489.21
FORMS: CMS-485
OMB NO: 0938-0358 EXPIRATION DATE: 12/31/2003
RESPS:2,580 HOURS:645 COSTS(000):$0
Psychiatric Unit Criteria Work Sheet, Rehabilitation Unit
Criteria Work Sheet and Rehabilitation Hospital Criteria Work
Sheet, and Supporting Regulations at 42 CFR 412.20 - 412.30
FORMS: HCFA-437 437A 437B
OMB NO: 0938-0359 EXPIRATION DATE: 03/31/2005
RESPS:899,340 HOURS:26,982 COSTS(000):$0
Medical Records Review Under PPS and Supporting Regulations at
42 CFR 412.40-412.52
FORMS: CMS-R-50
OMB NO: 0938-0360 EXPIRATION DATE: 11/30/2003
RESPS:675 HOURS:1,626 COSTS(000):$0
End Stage Renal Disease Application and Survey and Certification
Report Form and Supporting Regulations 42 CFR 405.2100 - 405.2184
FORMS: HCFA-3427
OMB NO: 0938-0365 EXPIRATION DATE: 05/31/2004
RESPS:7,500 HOURS:862,585 COSTS(000):$0
Home Health Medicare Conditions of Participation (CoP)
Information Collection Requirements as Outlined in Regulation --
42 CFR 484
FORMS: HCFA-R-39
OMB NO: 0938-0372 EXPIRATION DATE: 03/31/2004
RESPS:8,600 HOURS:717 COSTS(000):$0
ESRD Beneficiary Selection and Supporting Regulations Contained
in 42 CFR 414.330
FORMS: HCFA-382
OMB NO: 0938-0373 EXPIRATION DATE: 10/31/2005
RESPS:6,250 HOURS:1,563 COSTS(000):$0
Medicare Participating Physician or Supplier Agreement; CMS-460
FORMS: CMS-460
OMB NO: 0938-0378 EXPIRATION DATE: 08/31/2004
RESPS:250 HOURS:125 COSTS(000):$0
The Medicare/Medicaid Psychiatric Hospital Survey Data Contained
in 42 CFR and Supporting Regultions in 42 CFR 482.60, 482.61,
and 482.62
FORMS: HCFA-724
OMB NO: 0938-0379 EXPIRATION DATE: 08/31/2003
RESPS:2,293 HOURS:5,733 COSTS(000):$0
Hospice Survey and Deficiencies Report Form and Supporting
Regulations at 42 CFr Part 418.1 - 418.405
FORMS: 643
OMB NO: 0938-0380 EXPIRATION DATE: 08/31/2003
RESPS:2,000 HOURS:500 COSTS(000):$0
Hospital Request for Certification in the Medicare/Medicaid
Program
FORMS: HCFA-1514
OMB NO: 0938-0386 EXPIRATION DATE: 04/30/2003
RESPS:3,940 HOURS:143,721 COSTS(000):$0
Conditions for Coverage of Suppliers of End Stage Renal Disease
(ESRD) Services and Supporting Regulations Contained in 42 CFR
405.2100-.2171
FORMS: HCFA-R-52
OMB NO: 0938-0391 EXPIRATION DATE: 02/28/2006
RESPS:60,000 HOURS:120,000 COSTS(000):$0
Statement of Deficiencies and Plan of Correction and Supporting
Regulations Contained in 42 CFR 488.18, 488.26, and 488.28
FORMS: CMS-2567
OMB NO: 0938-0408 EXPIRATION DATE: 07/31/2003
RESPS:25 HOURS:2,000 COSTS(000):$0
Methodology for Estimating Waiver Costs of HCFA Demonstration
Projects
FORMS: HCFA-482
OMB NO: 0938-0426 EXPIRATION DATE: 02/28/2006
RESPS:3,729 HOURS:60,919 COSTS(000):$0
Information Collection Requirements in HSQ-110, Acquisition,
Protection and Disclosure of Peer Review Organization
Information and Supporting Regulations in 42 CFR, Section
480.104, 480.105,..
FORMS: CMS-R-70
OMB NO: 0938-0429 EXPIRATION DATE: 05/31/2004
RESPS:2 HOURS:20 COSTS(000):$0
Imposition of Cost Sharing Charges Under Medicaid and Supporting
Regulations contained in 42 CFR Section 447.53
FORMS: HCFA-R-0053
OMB NO: 0938-0443 EXPIRATION DATE: 04/30/2003
RESPS:15,670 HOURS:3,578 COSTS(000):$0
Information Collection Requirements in 42 CFR 473.18, 473.34,
473.36, and 473.42, PRO Reconsideration and Appeals
FORMS: HCFA-R-72
OMB NO: 0938-0444 EXPIRATION DATE: 10/31/2005
RESPS:1,060 HOURS:22,684 COSTS(000):$0
Information Collection Requirements in Final Peer Review
Organizations Sanction Regulations -- 42 CFR Sections 1004.40,
1004.50, 1004.60, and 1004.70
FORMS: HCFA-R-65
OMB NO: 0938-0445 EXPIRATION DATE: 08/31/2005
RESPS:6,036 HOURS:81,818 COSTS(000):$0
Information Collection Requirements in HSQ-108F Assumption of
Responsibilities and Supporting Regulations in 42 CFR Sections
412.44, 412.46, 431.630, 456.654, 476.71, 476.73, 476.74, 476.78
FORMS: HCFA-R-71
OMB NO: 0938-0447 EXPIRATION DATE: 04/30/2003
RESPS:3,761 HOURS:30,088 COSTS(000):$0
End Stage Renal Disease Medical Information System ESRD Facility
Survey
FORMS: HCFA-2744
OMB NO: 0938-0448 EXPIRATION DATE: 03/31/2006
RESPS:63,000 HOURS:10,710 COSTS(000):$0
End Stage Renal Disease Death Notification P. L. 95-292;
42CFR405.2133; CFR401,422E
FORMS: CMS-2746
OMB NO: 0938-0449 EXPIRATION DATE: 07/31/2005
RESPS:132 HOURS:7,930 COSTS(000):$0
Home and Community-Based Waiver Requests and Supporting
Regulations; 42 CFR 440.180, 441.300-.310
FORMS: CMS-8003
OMB NO: 0938-0454 EXPIRATION DATE: 04/30/2003
RESPS:947,816 HOURS:417,239 COSTS(000):$0
Physician Certifications/Recertifications in Skilled Nursing
Facilities (SNFs) Manual Instructions and Supporting Regulations
42 CFR 424.20
FORMS: HCFA-R-5
OMB NO: 0938-0456 EXPIRATION DATE: 10/31/2003
RESPS:1,350 HOURS:2,700 COSTS(000):$0
Indirect Medical Education (IME) And Supporting Regulations 42
CFR 412.105
FORMS: HCFA-R-64
OMB NO: 0938-0463 EXPIRATION DATE: 05/31/2004
RESPS:15,700 HOURS:2,943,354 COSTS(000):$0
Skilled Nursing Facility and Skilled Nursing Facility Cost
Report and Supporting Regulations in 42 CFR 413.20, 413.24, and
413.106
FORMS: HCFA-2540-96
OMB NO: 0938-0465 EXPIRATION DATE: 11/30/2003
RESPS:3,563,304 HOURS:296,942 COSTS(000):$0
Limitation on Liability and Information Collection Requirements
Referenced in 42 CFR 411.404, 411.406, and 411.408
FORMS: HCFA-R-77
OMB NO: 0938-0467 EXPIRATION DATE: 10/31/2005
RESPS:54 HOURS:99,254 COSTS(000):$0
Income and Eligibility Verification System Reporting and
Supporting Regulations
FORMS: R-0074
OMB NO: 0938-0469 EXPIRATION DATE: 12/31/2004
RESPS:300 HOURS:3,130 COSTS(000):$6,000
The Fiscal Soundness Reporting Requirements (FSRR)
FORMS: 906
OMB NO: 0938-0470 EXPIRATION DATE: 11/30/2003
RESPS:35 HOURS:3,500 COSTS(000):$471
Qualification Application and Supporting Regulations in 42 CFR,
Section 417.408 and 417.143
FORMS: HCFA-901-1
OMB NO: 0938-0477 EXPIRATION DATE: 07/31/2005
RESPS:40 HOURS:160 COSTS(000):$0
Payment Adjustment for Sole Community Hospitals and Supporting
Regulations in 42 CFR Section 412.92
FORMS: CMS-R-79
OMB NO: 0938-0484 EXPIRATION DATE: 04/30/2003
RESPS:1,100 HOURS:275 COSTS(000):$0
Emergency and Foreign Hospital Services -- Beneficiary Statement
in Canadian Travel Claims and Supporting Regulations in 42 CFR,
Section 424.123
FORMS: HCFA-R-96
OMB NO: 0938-0486 EXPIRATION DATE: 10/31/2003
RESPS:10,000 HOURS:2,500 COSTS(000):$0
Regulations for Hearing for Part A Medicare by an Administrative
Law Judge and Supporting Regulations in 42 CFR, 498 Subpart D
and E
FORMS: HCFA-5011A-U6
OMB NO: 0938-0490 EXPIRATION DATE: 10/31/2005
RESPS:4 HOURS:400 COSTS(000):$0
Criteria for Medicare Coverage of Heart Transplants
FORMS: CMS-R-106
OMB NO: 0938-0501 EXPIRATION DATE: 04/30/2004
RESPS:4,300 HOURS:731 COSTS(000):$0
Medicare Qualification Statement for Federal Employees and
Supporting Regulations in 42 CFR 406.15
FORMS: HCFA-565
OMB NO: 0938-0502 EXPIRATION DATE: 01/31/2006
RESPS:1,900,000 HOURS:329,965 COSTS(000):$0
Medicaid - Determining Third Party Liability (TPL) State Plan
Preprint and Supporting Regulations in 42 CFR 433.138
FORMS: CMS-R-107
OMB NO: 0938-0507 EXPIRATION DATE: 06/30/2003
RESPS:85,000 HOURS:2,805 COSTS(000):$0
Medicare Managed Care Disenrollment Form
FORMS: HCFA-566
OMB NO: 0938-0512 EXPIRATION DATE: 11/30/2003
RESPS:69 HOURS:138 COSTS(000):$0
Organ Procurement Organization's Request for Designation and
Supporting Regulations in 42 CFR 486.301 - 486.325
FORMS: CMS-576
OMB NO: 0938-0526 EXPIRATION DATE: 08/31/2004
RESPS:53 HOURS:1 COSTS(000):$0
Peer Review Organization Contracts: Solicitation of Statements
of Interest from In-State Organizations, General Notice--CFR 475
FORMS: HCFA-R-118
OMB NO: 0938-0534 EXPIRATION DATE: 05/31/2003
RESPS:500,000 HOURS:50,000 COSTS(000):$0
Attending Physician's Certification of Medical Necessity for
Home Oxygen Therapy and Supporting Regulations 42 CFR 410.38 and
42 CFR 424.5
FORMS: CMS-484
OMB NO: 0938-0544 EXPIRATION DATE: 02/28/2006
RESPS:13,250 HOURS:6,625 COSTS(000):$0
Survey Report Form Clinical Laboratory Improvement Amendments
(CLIA) and Supporting Regulations in 42 CFR 493.1-493.2001
FORMS: HCFA-1557
OMB NO: 0938-0565 EXPIRATION DATE: 11/30/2005
RESPS:327,947 HOURS:1,096,466 COSTS(000):$0
Internal Revenue Service/Social Security Administration/Centers
for Medicare & Medicaid Services Data Match and Supporting
Regulations in 42 CFR Sections 411.20-411.206
FORMS: CMS-R-137
OMB NO: 0938-0566 EXPIRATION DATE: 06/30/2003
RESPS:19,660,110 HOURS:1,638,345 COSTS(000):$122,700
Advance Beneficiary Notice and Supporting Regulations in 42 CFR
411.404, 411.406, and 411.408
FORMS: CMS-R-131
OMB NO: 0938-0567 EXPIRATION DATE: 10/31/2003
RESPS:1,000 HOURS:2,500 COSTS(000):$0
Request for Hearing for Part B Medicare by an Administrative Law
Judge and Supporting Regulations in 42 CFR, 498 Subpart D and E
FORMS: HCFA-5011B-U6
OMB NO: 0938-0568 EXPIRATION DATE: 04/30/2004
RESPS:49,500 HOURS:50,325 COSTS(000):$0
Medicare Current Beneficiary Survey (MCBS): Rounds 29-37
FORMS: HCFA-P-15A
OMB NO: 0938-0573 EXPIRATION DATE: 10/31/2005
RESPS:650 HOURS:650 COSTS(000):$0
Medicare Geographic Classification Review Board (MGCRB)
Procedures and Criteria and Supporting Regulations in 42 CFR,
Section 412.256 and 412.230
FORMS: CMS-R-0138
OMB NO: 0938-0575 EXPIRATION DATE: 07/31/2003
RESPS:50 HOURS:150 COSTS(000):$0
Analysis of Malpractice Premium Data
FORMS: HCFA-R-143
OMB NO: 0938-0578 EXPIRATION DATE: 07/31/2003
RESPS:2,204 HOURS:54,660 COSTS(000):$948
Medicaid Drug Rebate Program - Manufacturers
FORMS: HCFA-367 HCFA-367A HCFA-367B HCFA-367C
OMB NO: 0938-0579 EXPIRATION DATE: 04/30/2003
RESPS:20 HOURS:535 COSTS(000):$0
Business Proposal Formats for Utilization and Quality Control
Peer Review Organizations (PROs)
FORMS: 718-BP 719-BP 720-BP 721-BP SUM-PS IS CA SS SC-1 SC-2
OMB NO: 0938-0580 EXPIRATION DATE: 04/30/2004
RESPS:12 HOURS:2,110 COSTS(000):$0
Criteria for Medicare Coverage of Liver Transplants
FORMS: HCFA-R-108
OMB NO: 0938-0581 EXPIRATION DATE: 09/30/2004
RESPS:16,000 HOURS:20,000 COSTS(000):$0
Clinical Laboratory Improvement Amendments Application Form 42
CFR 493.1-.2001
FORMS: HCFA-116
OMB NO: 0938-0582 EXPIRATION DATE: 09/30/2003
RESPS:204 HOURS:6,125 COSTS(000):$139
State Drug Rebate (Medicaid)
FORMS: HCFA-368 R-144
OMB NO: 0938-0599 EXPIRATION DATE: 11/30/2004
RESPS:50 HOURS:4,500 COSTS(000):$0
CLIA Budget Workload Reports and Supporting Regulations
Contained in 42 CFR 493.1-.2001
FORMS: CMS-102 CMS-105
OMB NO: 0938-0600 EXPIRATION DATE: 10/31/2005
RESPS:186,800 HOURS:1,120,800 COSTS(000):$0
Medicare Credit Balance Reporting Requirements and Supporting
Regulations in 42 CFR 405.371, 405.378, and 413.20
FORMS: CMS-838
OMB NO: 0938-0610 EXPIRATION DATE: 07/31/2005
RESPS:34,365 HOURS:960,500 COSTS(000):$0
Information Collection Requirements Contained in BDP-718:
Advanced Directives (Medicare and Medicaid) and Supporting
Regulations in 42 CFR Sections 417.436, 417.801, 422.128,....
FORMS: HCFA-R-10
OMB NO: 0938-0612 EXPIRATION DATE: 06/30/2004
RESPS:700,650 HOURS:10,230,714 COSTS(000):$0
Clinical Laboratory Improvement Amendments (CLIA) and the ICRs
contained in the supporting regulations in 42 CFR 493.1-.2001
FORMS: HCFA-R-26
OMB NO: 0938-0618 EXPIRATION DATE: 01/31/2005
RESPS:40 HOURS:2,880 COSTS(000):$0
Limitations on Provider Related Donations and Health Care
Related Taxes; Limitation on payments to Disproportionate Share
Hospitals; Medicaid and Supporting Regulations in 42 CFR 433.68,.
FORMS: HCFA-R-148
OMB NO: 0938-0624 EXPIRATION DATE: 04/30/2003
RESPS:50 HOURS:12 COSTS(000):$0
Hospital Provider of Extended Care Services (Swing-Beds) in the
Medicare and Medicaid Programs, 42 CFR 447.280 and 482.66
FORMS: HCFA-605
OMB NO: 0938-0626 EXPIRATION DATE: 04/30/2003
RESPS:10,000 HOURS:1,250 COSTS(000):$0
Authorization Agreement for Electronic Funds Transfer
FORMS: HCFAA-588
OMB NO: 0938-0650 EXPIRATION DATE: 05/31/2004
RESPS:4,000 HOURS:10,000 COSTS(000):$0
Alternate Quality Assessment Survey
FORMS: HCFA-667
OMB NO: 0938-0653 EXPIRATION DATE: 08/31/2003
RESPS:12,500 HOURS:3,125 COSTS(000):$0
Post Laboratory Survey Questionnaire--Laboratory, and Supporting
Regulations in 42 CFR 493
FORMS: 668B
OMB NO: 0938-0655 EXPIRATION DATE: 10/31/2003
RESPS:1,573 HOURS:786 COSTS(000):$0
Clinical Laboratory Improvement Amendments (CLIA) Adverse Action
Extract and Supporting Regulations at 42 CFr 493.1840
FORMS: HCFA-462A/B
OMB NO: 0938-0657 EXPIRATION DATE: 12/31/2003
RESPS:36 HOURS:108 COSTS(000):$0
End-Stage Renal Disease (ESRD) Network Semi-Annual Cost Report
Forms and Supporting Regulations in 42 CFR 405.2110 and 42 CFR
405.2112
FORMS: HCFA-685
OMB NO: 0938-0658 EXPIRATION DATE: 12/31/2003
RESPS:36 HOURS:1,080 COSTS(000):$0
End-Stage Renal Disease (ESRD) Network Business Proposal Forms
and Supporting Regulations in 432 CFR 405.2110 and 42 CFR
405.2112
FORMS: HCFA-684A-684I
OMB NO: 0938-0667 EXPIRATION DATE: 11/30/2005
RESPS:5,600 HOURS:1 COSTS(000):$0
ICRs Contained in BPD-393, Examination and Treatment for
Emergency Medical Conditions and Women in Labor, 42 CFR 482.12,
488.18, 489.20, and 489.24, and HCFA-1005-IFC,....
FORMS: CMS-R-142
OMB NO: 0938-0670 EXPIRATION DATE: 05/31/2004
RESPS:6 HOURS:1,010 COSTS(000):$0
Criteria for Medicare Coverage of Lung Transplants
FORMS: HCFA-R-170
OMB NO: 0938-0673 EXPIRATION DATE: 07/31/2004
RESPS:5 HOURS:15 COSTS(000):$0
Medicaid Post-Eligibility Preprint--And Supporting Regulations
at 42 CFR 430.10
FORMS: SP0001
OMB NO: 0938-0676 EXPIRATION DATE: 05/31/2004
RESPS:3,744 HOURS:139,560 COSTS(000):$350
Reconciliation of State Invoice and Prior Quarter Adjustment
Statement (Medicaid Drug Rebate Program - Labelers)
FORMS: HCFA-304 HCFA-304A
OMB NO: 0938-0679 EXPIRATION DATE: 04/30/2003
RESPS:6,700,000 HOURS:1,130,000 COSTS(000):$0
Durable Medical Equipment Regional Carrier, Certificate of
Medical Necessity
FORMS: CMS-841 CMS-842 CMS-844 CMS-853
OMB NO: 0938-0685 EXPIRATION DATE: 04/30/2003
RESPS:274,000 HOURS:642,000 COSTS(000):$0
Medicare Federal Health Care Provider/Supplier Enrollment
Application
FORMS: HCFA-855A HCFA-855B HCFA-855I HCFA-855R HCFA-855S
OMB NO: 0938-0686 EXPIRATION DATE: 03/31/2005
RESPS:76 HOURS:768 COSTS(000):$0
Granting and Withdrawal of Deeming Authority to Private
Nonprofit Accrediation Organizations and of State Exemption
Under State Laboratory Programs & Supporting Regulation in 42
CFR 493.551-...
FORMS: HCFA-R-185
OMB NO: 0938-0690 EXPIRATION DATE: 10/31/2005
RESPS:28 HOURS:451 COSTS(000):$0
Granting and Withdrawal of Deeming Authority to National
Accreditation Organizations and Supporting Regulations at 42 CFR
488.4-488.9, and 488.201
FORMS: CMS-R-191
OMB NO: 0938-0691 EXPIRATION DATE: 10/31/2005
RESPS:100 HOURS:100 COSTS(000):$0
Medicare Disproportionate Share Adjustment Procedures and
Criteria and Supporting Regulations in 42 CFR 412.106
FORMS: CMS-R-194
OMB NO: 0938-0692 EXPIRATION DATE: 01/31/2006
RESPS:11,800,000 HOURS:196,666 COSTS(000):$0
"Important Message from Medicare" Title XVII Section 1866(a)(1)
(M), 42 CFR Section 466.78, 489.20, and 489.27
FORMS: CMS-R-193
OMB NO: 0938-0697 EXPIRATION DATE: 12/31/2003
RESPS:57 HOURS:342 COSTS(000):$0
Medicaid Report on Payables and Receivables
FORMS: HCFA-R-199
OMB NO: 0938-0700 EXPIRATION DATE: 04/30/2004
RESPS:450 HOURS:45,000 COSTS(000):$0
Incentive Arrangement Disclosure Form and Supporting Regulations
42 CFR 417.479, 417.500, 422.208, 422.210, 434.44, 434.67,
434.70, 1003.100, 1003.101, 1003.103, 1003.106
FORMS: HCFA-R-201
OMB NO: 0938-0701 EXPIRATION DATE: 09/30/2003
RESPS:313,825 HOURS:186,320 COSTS(000):$0
Health Plan Employer Data and Information Set (HEDIS ) and
Health Outcome Survey (HOS) and Supporting Regulations at CFR
422.152
FORMS: CMS-R-200
OMB NO: 0938-0702 EXPIRATION DATE: 04/30/2003
RESPS:43,000,000 HOURS:2,700,000 COSTS(000):$0
Information Collection Requirements Referenced in HIPAA for the
Group Market -- Supporting Regulations 45 CFR 146 and
Forms/Instructions
FORMS: HCFA-R-206
OMB NO: 0938-0703 EXPIRATION DATE: 04/30/2003
RESPS:3,230,000 HOURS:923,000 COSTS(000):$0
Information Collection Requirements Referenced in HIPAA for the
Form/Instructions
FORMS: HCFA-R-205
OMB NO: 0938-0705 EXPIRATION DATE: 10/31/2003
RESPS:92,803 HOURS:415 COSTS(000):$0
"Maximizing the Effective Use of Telemedicine: A Study of the
Effects, Cost Effectiveness and Utilization Patterns of
Consultations via Telemedicine"
FORMS: HCFA-R-197
OMB NO: 0938-0707 EXPIRATION DATE: 05/31/2005
RESPS:42 HOURS:6,720 COSTS(000):$0
Model Application Template for State Child Health Plan Under
Title XXI of the Social Security Act, State Children's Health
Insurance Program, & Model Application Template and Instructions
FORMS: HCFA-R-211
OMB NO: 0938-0708 EXPIRATION DATE: 04/30/2004
RESPS:1,200 HOURS:744 COSTS(000):$0
Evaluation of the State Medicaid Reform Demonstrations and
Evaluation of the Medicaid Health Reform Demonstrations
FORMS: HCFA-R-207
OMB NO: 0938-0709 EXPIRATION DATE: 03/31/2004
RESPS:69,717 HOURS:32,917 COSTS(000):$0
Data Collection for the Second Generation Social Health
Maintenance Organization Demonstration
FORMS: HCFA-R-204
OMB NO: 0938-0714 EXPIRATION DATE: 10/31/2004
RESPS:200 HOURS:2,000 COSTS(000):$0
Procedures for Advisory Opinions Concerning Physician Referrals
and Supporting Regulations in 42 CFR Sections 411.370 through
411.389
FORMS: HCFA-R-216
OMB NO: 0938-0717 EXPIRATION DATE: 11/30/2004
RESPS:35,000 HOURS:280,000 COSTS(000):$0
Information Collection Requirements Referenced in 42 CFR Section
424.57: Additional DMEPOS Supplier Standards
FORMS: HCFA-R-215
OMB NO: 0938-0721 EXPIRATION DATE: 08/31/2004
RESPS:500 HOURS:42 COSTS(000):$0
Independent Diagnostic Testing Facility and Supporting
Regulations Contained in 42 CFR 410.33
FORMS: HCFA-R-214
OMB NO: 0938-0722 EXPIRATION DATE: 09/30/2004
RESPS:10 HOURS:100 COSTS(000):$0
Medicare+Choice Provider Sponsored Organization Waiver Request
Form and Supporting Regulations at 42 CFR 422.370 through 422.378
FORMS: HCFA-R-231
OMB NO: 0938-0723 EXPIRATION DATE: 10/31/2005
RESPS:5 HOURS:1,000 COSTS(000):$0
Medicare Integrity Program Organizational Conflict of Interest
Disclosure Certificate and Supporting Regultions at 42 CFR
421.300 - 421.318
FORMS: HCFA-R-232
OMB NO: 0938-0730 EXPIRATION DATE: 08/31/2004
RESPS:26,280 HOURS:7,197 COSTS(000):$0
Subpart D-Private Contracts and Supporting Regulations in 42 CFR
405.410, 405.430, 405.435, 405.440, 405.445, 405.455, 410.61,
415.110, and 424.24
FORMS: R-234
OMB NO: 0938-0731 EXPIRATION DATE: 04/30/2005
RESPS:448 HOURS:7,840 COSTS(000):$0
Quarterly Children's Health Insurance Program Statement of
Expenditures for Title XXI
FORMS: HCFA-21 HCFA-21B
OMB NO: 0938-0732 EXPIRATION DATE: 05/31/2004
RESPS:168,000 HOURS:55,450 COSTS(000):$0
The Medicare Managed Care CAHPS Survey and Supporting
Regulations in 42 CFR 417.126 and 417.470
FORMS: HCFA-R-246
OMB NO: 0938-0734 EXPIRATION DATE: 09/30/2004
RESPS:1,500 HOURS:750 COSTS(000):$0
Data Use Agreement Information Collection Requirements, model
language, and supporting regulations in 42 CFR Section 5b
FORMS: HCFA-R-235
OMB NO: 0938-0738 EXPIRATION DATE: 11/30/2005
RESPS:2,400 HOURS:600 COSTS(000):$0
National Medicare Education Program (NMEP) Community Survey of
Medicare Beneficiaries
FORMS: CMS-R-254
OMB NO: 0938-0739 EXPIRATION DATE: 03/31/2006
RESPS:2,657,859 HOURS:2,640,371 COSTS(000):$0
SNF Resident Assessment MDS Data and Supporting Regulations in
42 CFR 413,337, 413.343, 424.32, and 483.20
FORMS: CMS-R-250
OMB NO: 0938-0741 EXPIRATION DATE: 12/31/2005
RESPS:50,000 HOURS:3,300 COSTS(000):$0
Medicare+Choice Disenrollment Form to Original Medicare and
Supporting Regulations 422.66
FORMS: CMS-R-257
OMB NO: 0938-0742 EXPIRATION DATE: 04/30/2003
RESPS:700 HOURS:66,500 COSTS(000):$0
Adjusted Community Rate (ACR) Proposal medicare + Choice
FORMS: CMS-R-228
OMB NO: 0938-0746 EXPIRATION DATE: 10/31/2005
RESPS:54 HOURS:2,160 COSTS(000):$0
Medicaid Disproportionate Share Hospital/Institutions for Mental
Disease
FORMS: CMS-R-266
OMB NO: 0938-0748 EXPIRATION DATE: 12/31/2003
RESPS:1,700 HOURS:12,420 COSTS(000):$0
Medicare DMEPOS Competitive Bidding Demonstration
FORMS: HCFA-R-0264A-H
OMB NO: 0938-0749 EXPIRATION DATE: 10/31/2004
RESPS:20,000 HOURS:10,000 COSTS(000):$0
On-Site Inspection for Durable Medical Equipment (DME) Supplier
Location and Supporting Regulations in 42 CFR, Section 424.57
FORMS: HCFA-R-263
OMB NO: 0938-0753 EXPIRATION DATE: 10/31/2005
RESPS:7,657,534 HOURS:2,120,006 COSTS(000):$0
Medicare Plus Choice Program Requirements Referenced in 42 CFR
422.000-422.700
FORMS: CMS-R-0267
OMB NO: 0938-0754 EXPIRATION DATE: 03/31/2005
RESPS:80,000 HOURS:1 COSTS(000):$0
Inpatient Psychiatric Services for Individuals Under Age 21 and
Supporting regulations in 42 CFR 441.152
FORMS: CMS-R-238
OMB NO: 0938-0756 EXPIRATION DATE: 03/31/2005
RESPS:7,000 HOURS:583 COSTS(000):$0
MSInteractive Survey Tool for www.medicare.gov
FORMS: CMS-R-268
OMB NO: 0938-0758 EXPIRATION DATE: 03/31/2005
RESPS:1,720 HOURS:302,720 COSTS(000):$0
Hospice Cost Report and Supporting Regulations in 42 CFR 413.20
and 413.24
FORMS: CMS-R-249
OMB NO: 0938-0760 EXPIRATION DATE: 07/31/2003
RESPS:9,510,900 HOURS:8,013,013 COSTS(000):$0
Medicare and Medicaid Programs Use of the OASIS as Part of the
CoPs for HHAs and Supporting Regulations in Part 484 of 42 CFR
FORMS: CMS-R-245
OMB NO: 0938-0761 EXPIRATION DATE: 07/31/2003
RESPS:85,200 HOURS:838,408 COSTS(000):$17,800
Medicare and Medicaid Programs: Use and Reporting OASIS Data as
Part of the CoPs for HHAs and Supporting Regulations in 42 CFR
484.11 and 484.20
FORMS: CMS-R-209
OMB NO: 0938-0763 EXPIRATION DATE: 04/30/2003
RESPS:300 HOURS:900 COSTS(000):$0
The Adjusted Community Rate Proposal (ACRP) M+C Plan Benefit
Package & Supporting Regulations in 42 CFR 417.401,
422.1-422.10,
422.50-422.80,422.100-422.132,422.300-422.312,422.400-422.404....
FORMS: HCFA-R-262
OMB NO: 0938-0767 EXPIRATION DATE: 08/31/2004
RESPS:450 HOURS:75 COSTS(000):$0
Medigap Compare
FORMS: HCFA-R-0280
OMB NO: 0938-0768 EXPIRATION DATE: 05/31/2004
RESPS:10 HOURS:750 COSTS(000):$0
Medicare Agreement Application, Health Care Prepayment Plan and
Supporting Regulations in 42 CFR, Section 417.800-.840
FORMS: CMS-R-243
OMB NO: 0938-0769 EXPIRATION DATE: 03/31/2006
RESPS:1,500 HOURS:375 COSTS(000):$0
Request for Retirement Benefit Informatin (BBA '97)
FORMS: CMS-R285
OMB NO: 0938-0770 EXPIRATION DATE: 12/31/2005
RESPS:4,550 HOURS:17,400 COSTS(000):$0
Site Visit Assessment Tool (previously known as Community Mental
Health Center Site Visit Assessment Tool) and Supporting
Regulations in 432 CFR 410.2
FORMS: CMS-R-273
OMB NO: 0938-0776 EXPIRATION DATE: 09/30/2004
RESPS:200 HOURS:8,000 COSTS(000):$0
Medicare Program: Procedures for Making National Coverage
Decisions
FORMS: CMS-R-0290
OMB NO: 0938-0777 EXPIRATION DATE: 04/30/2003
RESPS:9,000 HOURS:1,500 COSTS(000):$0
Medicare Lifestyle Modification Program Demonstration
FORMS: HCFA-R-289
OMB NO: 0938-0778 EXPIRATION DATE: 12/31/2003
RESPS:536 HOURS:1,608 COSTS(000):$0
Medicare + Choice (M + C) Organization Appeals and Grievance
Data Disclosure Requirements and Supporting Regulations in 42
CFR 42 CFR 422.64, 422.11, and 422.560 - 422.622
FORMS: HCFA-R-0282
OMB NO: 0938-0779 EXPIRATION DATE: 07/31/2005
RESPS:90,240 HOURS:42,112 COSTS(000):$0
Medicare CAHPS Disenrollment Surveys
FORMS: CMS-R-295
OMB NO: 0938-0780 EXPIRATION DATE: 03/31/2005
RESPS:10,000 HOURS:833 COSTS(000):$0
Medicare Telephone Customer Satisfaction Survey
FORMS: CMS-R-293
OMB NO: 0938-0781 EXPIRATION DATE: 06/30/2005
RESPS:145,966 HOURS:14,597 COSTS(000):$0
Information Collection Requirements and Supporting Regulations
in 42 CFR, Section 484.10(a)
FORMS: CMS-R-296
OMB NO: 0938-0786 EXPIRATION DATE: 04/30/2003
RESPS:11,609 HOURS:135,110 COSTS(000):$0
External Quality Review of Medicaid MCOs and Supporting
Regulations in 42 CFR 438.360, 438.362, and 438.364
FORMS: HCFA-R-0305
OMB NO: 0938-0787 EXPIRATION DATE: 08/31/2004
RESPS:5,000 HOURS:750 COSTS(000):$0
Request for Employment Information
FORMS: HCFA-R-297
OMB NO: 0938-0790 EXPIRATION DATE: 01/31/2006
RESPS:54 HOURS:44,078 COSTS(000):$0
Medicare and Medicaid: Programs of All-inclusive Care for the
Elderly (PACE) Contained in 42 CFR 460.12-460.210/Medicare and
Medicaid: Program of All-inclusive Care for the Elderly (PACE);..
FORMS: CMS-R-244
OMB NO: 0938-0791 EXPIRATION DATE: 03/31/2004
RESPS:90,070 HOURS:22,503 COSTS(000):$0
A Project to Develop an Outcome-Based Continuous Quality
Improvement System and Core Outcome and Comprehensive Assessment
Data Set for PACE
FORMS: CMS-R-299
OMB NO: 0938-0792 EXPIRATION DATE: 04/30/2003
RESPS:3,573 HOURS:3,663 COSTS(000):$0
Rural Health Clinics: Amendments to Participation Requirements &
Payment Provisions; & Establishments of a Quality Assessment &
Performance Improvement Program & Supporting Regulations.....
FORMS: HCFA-R-0242
OMB NO: 0938-0795 EXPIRATION DATE: 08/31/2004
RESPS:37 HOURS:11,100 COSTS(000):$0
Conflict of Interest and Ownership and Control Information
FORMS: HCFA-R-312
OMB NO: 0938-0796 EXPIRATION DATE: 05/31/2004
RESPS:134,400 HOURS:44,800 COSTS(000):$0
Medicare Consumer Assessment of Health Plan Survey - Fee for
Service (CAHPS-FFS)
FORMS: HCFA-10000
OMB NO: 0938-0797 EXPIRATION DATE: 07/31/2003
RESPS:150 HOURS:566 COSTS(000):$0
Individual Market-Guarantee Issue Election Packet, Supporting
Regulations 45 CFR 148, and forms/instruction
FORMS: HCFA-R-205
OMB NO: 0938-0798 EXPIRATION DATE: 08/31/2003
RESPS:2,752 HOURS:41,063 COSTS(000):$0
Prospective Payments for Hospital Outpatient Services and
Supporting Regulations in 42 CFR 143.65, and 419.42
FORMS: HCFA-R-240
OMB NO: 0938-0799 EXPIRATION DATE: 09/30/2003
RESPS:56 HOURS:5,600 COSTS(000):$0
TWWIA Demonstration to Maintain Independence and Employment
FORMS: HCFA-10006
OMB NO: 0938-0801 EXPIRATION DATE: 08/31/2003
RESPS:51 HOURS:102 COSTS(000):$0
Evaluation of QMB and SLMB Outreach Activities
FORMS: HCFA-R-317
OMB NO: 0938-0802 EXPIRATION DATE: 05/31/2005
RESPS:55 HOURS:193 COSTS(000):$0
Recognition of pass-through payment for drugs and biologicals
under the Outpatient Prospective Payment System and Supporting
Regulations in 42 CFR, Section 419.43, formerly known as......
FORMS: CMS-10008
OMB NO: 0938-0806 EXPIRATION DATE: 08/31/2005
RESPS:10,043 HOURS:19,999 COSTS(000):$0
Informatics, Telemedicine, and Education Demonstration Project
FORMS: HCFA-10014
OMB NO: 0938-0808 EXPIRATION DATE: 10/31/2003
RESPS:2,174 HOURS:4,735 COSTS(000):$0
Study to Support Development and Refinement of a Classification
System and Prospective Payment System for Patients in Inpatient
Rehabilitation Hospitals and Exempt Rehabilitation Units
FORMS: HCFA-R-311
OMB NO: 0938-0810 EXPIRATION DATE: 11/30/2003
RESPS:1,491,700 HOURS:146,070 COSTS(000):$0
Hospital Condition of Participation; Identification of Potential
Organ, Tissue, & Eye Donors & Transplant Hospitals' Provision of
Transplant-Related Data & Supporting Regulation at 42 CFR 482.45
FORMS: HCFA-R-0294
OMB NO: 0938-0811 EXPIRATION DATE: 11/30/2003
RESPS:56 HOURS:5,600 COSTS(000):$0
Ticket to Work and Work Incentives: Medicaid Infrastructure
Grants
FORMS: HCFA-10005
OMB NO: 0938-0812 EXPIRATION DATE: 11/30/2003
RESPS:150 HOURS:37 COSTS(000):$0
Employee Building Pass Application and File
FORMS: HCFA-730 HCFA-182
OMB NO: 0938-0813 EXPIRATION DATE: 12/31/2003
RESPS:1,500 HOURS:500 COSTS(000):$0
Evaluation of the OMB and SLMB Programs -- Beneficiary Survey
FORMS: HCFA-10015
OMB NO: 0938-0817 EXPIRATION DATE: 11/30/2003
RESPS:3,600 HOURS:684 COSTS(000):$0
Survey of Medicare Beneficiaries Who Involuntarily Disenroll
From Their Health Plan
FORMS: CMS-10026
OMB NO: 0938-0818 EXPIRATION DATE: 05/31/2003
RESPS:3,291 HOURS:23,218 COSTS(000):$0
Expanded Coverage for Diabetes Outpatient Self-Management 42 CFR
410.141-410-145 and 414.63
FORMS: R-247
OMB NO: 0938-0819 EXPIRATION DATE: 05/31/2004
RESPS:2,600 HOURS:100 COSTS(000):$0
HIPAAA Nondiscrimination Provisions (Regulation HCFA-2078-P)
FORMS: HCFA-10009
OMB NO: 0938-0820 EXPIRATION DATE: 05/31/2003
RESPS:500 HOURS:542 COSTS(000):$0
Follow-Up of Medicare+Choice Disenrollees Receiving
Fee-for-Service Inpatient Hospital Care
FORMS: HCFA-10017
OMB NO: 0938-0823 EXPIRATION DATE: 04/30/2004
RESPS:150 HOURS:50 COSTS(000):$0
Suggestion Program on Methods to Improve Medicare Efficiency and
Supporting Regulations in 42 CFR 420.410
FORMS: HCFA-R-0255
OMB NO: 0938-0824 EXPIRATION DATE: 05/31/2004
RESPS:75 HOURS:3 COSTS(000):$0
Restraints/Seclusion Death Reporting for Hospitals and
Supporting Regulations at 42 CFR 482.13
FORMS: HCFA-10004
OMB NO: 0938-0826 EXPIRATION DATE: 06/30/2004
RESPS:4,800 HOURS:3,200 COSTS(000):$0
Survey of Medicaid Home and Community-Based Services Waiver and
Personal Care Option Recipients for the Multi-Site Study of
Medicaid HOme and Community-Based Services
FORMS: HCFA-10018
OMB NO: 0938-0827 EXPIRATION DATE: 05/31/2005
RESPS:18 HOURS:194 COSTS(000):$0
HIPA Nondiscrimination Provisions (Regulation HCFA-2022-IFC)
FORMS: HCFA-10001
OMB NO: 0938-0828 EXPIRATION DATE: 06/30/2004
RESPS:1,500 HOURS:500 COSTS(000):$0
Medicare Beneficiary Customer Service Survey
FORMS: HCFA-10022
OMB NO: 0938-0829 EXPIRATION DATE: 05/31/2004
RESPS:29,892 HOURS:2,994 COSTS(000):$0
Medicare+Choice Beneficiary Appeal Notices, "Notice of Denial of
Medical Services", "Notice of Denial of Request for Payment" and
Supporting Regulations in 42 CFR 422.568
FORMS: HCFA-10003
OMB NO: 0938-0832 EXPIRATION DATE: 07/31/2004
RESPS:3,000 HOURS:150 COSTS(000):$0
Health Insurance Benefit Agreement and Supporting Regulations at
42 CFR Part 489
FORMS: HCFA-1561
OMB NO: 0938-0833 EXPIRATION DATE: 03/31/2005
RESPS:2,600,000 HOURS:877,750 COSTS(000):$0
Restraint and Seclusion Standards for Psychiatric Residential
Treatment Facilities
FORMS: CMM-R-306
OMB NO: 0938-0836 EXPIRATION DATE: 02/28/2005
RESPS:108 HOURS:540 COSTS(000):$0
Real Choice Systems Change Grants; Nursing Facility Transition/
Access Housing Grants; Community Personal Assistance Service and
Supports Grants, National Technical Assistance and Learning.....
FORMS: CMS-10037
OMB NO: 0938-0837 EXPIRATION DATE: 03/31/2004
RESPS:5,250 HOURS:782 COSTS(000):$0
Medicare Program Integrity Customer Satisfaction Project
FORMS: CMS-10029
OMB NO: 0938-0840 EXPIRATION DATE: 09/30/2003
RESPS:125 HOURS:11 COSTS(000):$0
Collection of Data on Quality Indicators for Congestive Heart
Failure Submitted by Medicare+Choice Organizations Requesting
Extra Payments in CY2002 and CY2003 and Supporting Regulations...
FORMS: HCFA-10035
OMB NO: 0938-0841 EXPIRATION DATE: 06/30/2004
RESPS:3,748,463 HOURS:720,999 COSTS(000):$0
State Children's Health Insurance Program and Supporting
Regulations in 42 CFR.
FORMS: HCFA-0308
OMB NO: 0938-0842 EXPIRATION DATE: 07/31/2005
RESPS:359,000 HOURS:269,250 COSTS(000):$0
Inpatient Rehabilitation Assessment Instrument and Data Set for
PPS for Inpatient Rehabilitation Facilities and Supporting
Regulations in 42 CFR, Parts 412 and 413
FORMS: CMS-10036
OMB NO: 0938-0843 EXPIRATION DATE: 10/31/2004
RESPS:130,500 HOURS:58,000 COSTS(000):$0
Healthy Aging Smoking Cessation Demonstration
FORMS: HCFA-10012
OMB NO: 0938-0844 EXPIRATION DATE: 03/31/2005
RESPS:5,814 HOURS:1,082 COSTS(000):$0
Medicare Health Survey (MHS)
FORMS: CMS-10024
OMB NO: 0938-0846 EXPIRATION DATE: 10/31/2004
RESPS:1 HOURS:1 COSTS(000):$0
Physicians' Referral to Health Care Entities With Which They
Have Financial Relationships and Supporting Regulations in 42
CFR, Sections 411.1, 411.350 through 411.357 and 424.22
FORMS: CMS-10047
OMB NO: 0938-0847 EXPIRATION DATE: 04/30/2003
RESPS:3,900 HOURS:800 COSTS(000):$0
Long Term Care Awareness Project
FORMS: CMS-10041
OMB NO: 0938-0848 EXPIRATION DATE: 05/31/2005
RESPS:10 HOURS:80 COSTS(000):$0
Health Insurance Flexibility and Accountability Section 1115
Model Waiver
FORMS: 10048
OMB NO: 0938-0850 EXPIRATION DATE: 12/31/2003
RESPS:265 HOURS:159 COSTS(000):$0
State Health Insurance Assistance Program (SHIP) Client Report
FORMS: HCFA-10028A-C
OMB NO: 0938-0851 EXPIRATION DATE: 10/31/2005
RESPS:10,800 HOURS:2,700 COSTS(000):$0
Assessing the CMS Fall Campaigns
FORMS: CMS-10049
OMB NO: 0938-0852 EXPIRATION DATE: 11/30/2004
RESPS:384 HOURS:768 COSTS(000):$0
Durable Medicare Equipment and Prosthetics, Orthotics, and
Supplies (DMEPOS) Supplier Survey: Texas
FORMS: HCFA-10045
OMB NO: 0938-0857 EXPIRATION DATE: 01/31/2005
RESPS:100 HOURS:1,600 COSTS(000):$0
Recognition of pass-through payment for additional (new)
categories of devices under the Outpatient Prospective Payment
System and Supporting Regulations in 42 CFR, Part 419
FORMS: CMS-10052
OMB NO: 0938-0859 EXPIRATION DATE: 02/28/2005
RESPS:20,000 HOURS:5,000 COSTS(000):$0
NMEP Regional Survey of Medicare Beneficiaries
FORMS: CMS-10040
OMB NO: 0938-0860 EXPIRATION DATE: 03/31/2005
RESPS:25 HOURS:250 COSTS(000):$0
Recognition of payment for new technology services for
Ambulatory Payment Classification (APCs) under the Outpatient
Prospective Payment System and Supporting Regulation in.......
FORMS: CMS-10054
OMB NO: 0938-0863 EXPIRATION DATE: 02/28/2005
RESPS:5,680 HOURS:1,914 COSTS(000):$0
Evaluation of the BadgerCare Medicaid Demonstration
FORMS: HCFA-10043
OMB NO: 0938-0866 EXPIRATION DATE: 05/31/2005
RESPS:3,400,000 HOURS:34,000,000 COSTS(000):$0
ICRs Contained in 45 CFR Part 162; HIPAA Standards for
Electronic Transactions
FORMS: CMS-R-0218
OMB NO: 0938-0867 EXPIRATION DATE: 07/31/2003
RESPS:6,322 HOURS:1,581 COSTS(000):$0
Survey of Medicare Private Fee-for-service (PFFS) Enrollees and
Nonenrollees
FORMS: CMS-10059
OMB NO: 0938-0869 EXPIRATION DATE: 04/30/2003
RESPS:3,600 HOURS:1,080 COSTS(000):$0
Survey of Newly Eligible Medicare Beneficiaries
FORMS: CMS-10050
OMB NO: 0938-0871 EXPIRATION DATE: 07/31/2005
RESPS:1,680 HOURS:1,106 COSTS(000):$0
Medicare Lifestyle Modification Program Demonstration
FORMS: CMS-10044
OMB NO: 0938-0872 EXPIRATION DATE: 12/31/2005
RESPS:156,480 HOURS:132,360 COSTS(000):$6,395
Minimum Data Set (MDS) for Swing Bed Hospitals and Supporting
Regulations in 42 CFR 483.20 and 413.337
FORMS: CMS-10064
OMB NO: 0938-0873 EXPIRATION DATE: 08/31/2005
RESPS:250 HOURS:2,000 COSTS(000):$0
Quality Assessment and Performance Improvement (QAPI) Project
Completion Report, 42 CFR 422.152
FORMS: CMS-10060
OMB NO: 0938-0874 EXPIRATION DATE: 09/30/2005
RESPS:2,550,000 HOURS:1,700,000 COSTS(000):$51,000
HIPAA Standard Unique Employer Identifier and Supporting
Regulations in 45 CFR Part 160 and 162
FORMS: CMS-R-220
OMB NO: 0938-0875 EXPIRATION DATE: 04/30/2003
RESPS:129,000 HOURS:32,250 COSTS(000):$0
Durable Medical Equipment Regional Carrier, Certificate of
Medical Necessity
FORMS: CMS-843
OMB NO: 0938-0876 EXPIRATION DATE: 09/30/2005
RESPS:2,084 HOURS:348 COSTS(000):$0
Evaluation of the MassHealth Insurance Partnership
FORMS: CMS-10051
OMB NO: 0938-0877 EXPIRATION DATE: 07/31/2005
RESPS:11,356 HOURS:5,465 COSTS(000):$0
Evaluation of Programs of Coordinated Care and Disease Management
FORMS: CMS-10061
OMB NO: 0938-0878 EXPIRATION DATE: 10/31/2005
RESPS:6,605,691 HOURS:18,877 COSTS(000):$0
Collection of Diagnostic Data from Medicare+Choice Organizations
for Risk Adjusted Payment Supporting Regulations CFR Part 422
Subpart F & G
FORMS: CMS-10062
OMB NO: 0938-0879 EXPIRATION DATE: 10/31/2005
RESPS:1,350 HOURS:1,012 COSTS(000):$0
Making Good Choices Survey
FORMS: CMS-10065
OMB NO: 0938-0880 EXPIRATION DATE: 05/31/2003
RESPS:75 HOURS:1,600 COSTS(000):$0
Medicare Waiver Demonstration Application
FORMS: CMS-10069
OMB NO: 0938-0882 EXPIRATION DATE: 11/30/2005
RESPS:15 HOURS:5,189 COSTS(000):$0
Medicare Endorsed Prescription Drug Card Assistance Initiative
FORMS: CMS-10070
OMB NO: 0938-0883 EXPIRATION DATE: 12/31/2005
RESPS:776,224,162 HOURS:2,210,715 COSTS(000):$0
Standards for Privacy of Individually Identifiable Health
Information and Supporting Regulations at 45 CFR Parts 160 and
164
FORMS: HCFA-10039
OMB NO: 0938-0885 EXPIRATION DATE: 06/30/2003
RESPS:15 HOURS:5,444 COSTS(000):$0
Medicare-Endorsed Prescription Drug Card Assistance Initiative
FORMS: CMS-10076
OMB NO: 0938-0887 EXPIRATION DATE: 06/30/2003
RESPS:20 HOURS:800 COSTS(000):$0
Matching Grants to States for the Operation of High Risk Pools
FORMS: CMS-10078
OMB NO: 0938-0889 EXPIRATION DATE: 07/31/2003
RESPS:25 HOURS:115 COSTS(000):$0
Pharmacy Plus Template Application
FORMS: CMS-10067
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
232 2,694,335,512 139,506,338 $205,863
Administration for Children and Families
OMB NO: 0970-0004 EXPIRATION DATE: 04/30/2005
RESPS:1 HOURS:13,746 COSTS(000):$0
Annual Statistical Report on Children in Foster Homes and
Children in Famillies Receiving Payment in Excess of the Poverty
Income Level from a Program Funded Under Part A of Title IV....
FORMS: ACF-4125
OMB NO: 0970-0017 EXPIRATION DATE: 09/30/2004
RESPS:54 HOURS:90 COSTS(000):$0
Revised Form OCSE-100, State Plan for Child Support Collection
and Establishment of Paternity Under Title IV-D of the Social
Security Act
FORMS: OCSE-100
OMB NO: 0970-0030 EXPIRATION DATE: 08/31/2004
RESPS:48 HOURS:24 COSTS(000):$0
Refugee Resettlement Program Estimates: CMA
FORMS: ORR-1
OMB NO: 0970-0033 EXPIRATION DATE: 12/31/2003
RESPS:2,000 HOURS:1,350 COSTS(000):$0
Annual Survey of Refugees
FORMS: ORR-9
OMB NO: 0970-0036 EXPIRATION DATE: 06/30/2003
RESPS:81,130 HOURS:3,011 COSTS(000):$0
Regulation -- Refugee Resettlement Program: Requirements for
Refugee Cash Assistance; and Refugee Medical Assistance (45 CFR
Part 400)
FORMS: NONE
OMB NO: 0970-0037 EXPIRATION DATE: 12/31/2004
RESPS:1 HOURS:14 COSTS(000):$0
LIHEAP Quarterly Allocation Estimates Form ACF-535
FORMS: ACF-535
OMB NO: 0970-0043 EXPIRATION DATE: 05/31/2003
RESPS:50 HOURS:217 COSTS(000):$0
Refugee State of Origin Report
FORMS: ORR-11
OMB NO: 0970-0060 EXPIRATION DATE: 10/31/2003
RESPS:236 HOURS:2,108 COSTS(000):$0
Low Income Home Energy Assistance Program (LIHEAP) Household
Report
FORMS: NONE
OMB NO: 0970-0062 EXPIRATION DATE: 01/31/2004
RESPS:940 HOURS:20,300 COSTS(000):$0
Information collection from applicants who will respond to
Request for Applications for funding of OCS competitive grants
FORMS: NONE
OMB NO: 0970-0075 EXPIRATION DATE: 02/28/2005
RESPS:180 HOURS:103 COSTS(000):$0
Application Requirements for the Low Income Home Energy
Assistance Program (LIHEAP) Model Plan
FORMS: NONE
OMB NO: 0970-0076 EXPIRATION DATE: 08/31/2004
RESPS:51 HOURS:178 COSTS(000):$0
The Low Income Home Energy Assistance Program (LIHEAP) Grantee
Survey
FORMS: ACF-284
OMB NO: 0970-0085 EXPIRATION DATE: 12/31/2003
RESPS:44,471 HOURS:593,226 COSTS(000):$0
Provision of Services in Interstate Child Support Enforcement:
Standard Forms
FORMS: NONE
OMB NO: 0970-0106 EXPIRATION DATE: 11/30/2004
RESPS:177 HOURS:531 COSTS(000):$0
Low Income Home Energy Assistance Program (LIHEAP) Carryover and
Reallotment Report
FORMS: NONE
OMB NO: 0970-0114 EXPIRATION DATE: 02/29/2004
RESPS:28 HOURS:4,552 COSTS(000):$0
Child Care and Development Fund Plan for States/Territories
FORMS: ACF-118
OMB NO: 0970-0121 EXPIRATION DATE: 07/31/2003
RESPS:70 HOURS:2,660 COSTS(000):$0
Low Income Home Energy Assistance Program (LIHEAP) Leveraging
Report
FORMS: ACF-119
OMB NO: 0970-0123 EXPIRATION DATE: 04/30/2004
RESPS:135,080 HOURS:62,012 COSTS(000):$330
Runaway and Homeless Youth Management Information System
FORMS: NONE
OMB NO: 0970-0139 EXPIRATION DATE: 12/31/2003
RESPS:2,838 HOURS:22,704 COSTS(000):$0
ACF Uniform Project Description (UPD)
FORMS: NONE
OMB NO: 0970-0140 EXPIRATION DATE: 04/30/2003
RESPS:200 HOURS:4,800 COSTS(000):$0
Head Start Fellows Program
FORMS: NONE
OMB NO: 0970-0142 EXPIRATION DATE: 04/30/2003
RESPS:4,800 HOURS:4,800 COSTS(000):$10
Federal Parent Locator Service
FORMS: NONE
OMB NO: 0970-0145 EXPIRATION DATE: 07/31/2005
RESPS:54 HOURS:1,782 COSTS(000):$0
Temporary Assistance for Needy Families (TANF) State Plan
FORMS: NONE
OMB NO: 0970-0148 EXPIRATION DATE: 08/31/2003
RESPS:2,472 HOURS:1,468,626 COSTS(000):$0
Head Start Program Performance Standards-Final Rule
FORMS: NONE
OMB NO: 0970-0150 EXPIRATION DATE: 06/30/2003
RESPS:56 HOURS:2,800 COSTS(000):$224
Child Care and Development Fund Annual Report
FORMS: ACF-800
OMB NO: 0970-0151 EXPIRATION DATE: 10/31/2004
RESPS:1,749 HOURS:5,439 COSTS(000):$0
Head Start Family and Child Experiences survey
FORMS: NONE
OMB NO: 0970-0152 EXPIRATION DATE: 03/31/2004
RESPS:24,694 HOURS:12,347 COSTS(000):$0
Administrative Subpoena
FORMS: N/A
OMB NO: 0970-0153 EXPIRATION DATE: 03/31/2004
RESPS:29,776 HOURS:7,444 COSTS(000):$0
Notice of Lien
FORMS: N/A
OMB NO: 0970-0154 EXPIRATION DATE: 03/31/2004
RESPS:54 HOURS:16,056 COSTS(000):$0
Order/Notice to Withhold Income for Child Support
FORMS: N/A
OMB NO: 0970-0155 EXPIRATION DATE: 04/30/2005
RESPS:52 HOURS:3,328 COSTS(000):$0
Community-Based Family Resource and Support Program
FORMS: NONE
OMB NO: 0970-0157 EXPIRATION DATE: 06/30/2004
RESPS:20 HOURS:1,080 COSTS(000):$0
Guidance for the Tribal Temporary Assistance for Needy Families
Program
FORMS: NONE
OMB NO: 0970-0159 EXPIRATION DATE: 05/31/2005
RESPS:1 HOURS:1,000 COSTS(000):$0
Statewide Automated Child Welfare Information System (SACWIS)
Assessment Review Guide
FORMS: NONE
OMB NO: 0970-0160 EXPIRATION DATE: 11/30/2003
RESPS:25 HOURS:500 COSTS(000):$0
Procedures for Requests to Use Child Care and Development Fund
for Construction or Major Renovation of Child Care Facilities
FORMS: NONE
OMB NO: 0970-0161 EXPIRATION DATE: 04/30/2004
RESPS:7,074 HOURS:2,535 COSTS(000):$128
Federal Tax Offset, Administrative Offest, and Passport Denial
Programs
FORMS: NONE
OMB NO: 0970-0163 EXPIRATION DATE: 12/31/2003
RESPS:4 HOURS:1,792 COSTS(000):$3
Child Care and Development Fund Quarterly Financial Report
FORMS: ACF-696
OMB NO: 0970-0166 EXPIRATION DATE: 01/31/2004
RESPS:60,000,000 HOURS:1,962,402 COSTS(000):$86,400
National Directory of New Hires
FORMS: NONE
OMB NO: 0970-0167 EXPIRATION DATE: 03/31/2006
RESPS:224 HOURS:4,480 COSTS(000):$224
Child Care Case-Level Report
FORMS: ACF-801
OMB NO: 0970-0171 EXPIRATION DATE: 07/31/2004
RESPS:448,600 HOURS:74,468 COSTS(000):$0
Required Data Elements for Paternity Establishment Affidavits
FORMS: NONE
OMB NO: 0970-0173 EXPIRATION DATE: 05/31/2004
RESPS:1 HOURS:1,120 COSTS(000):$0
Request for State Data Needed to Determine the Amount of a
Tribal Family Assistance Grant
FORMS: NONE
OMB NO: 0970-0174 EXPIRATION DATE: 03/31/2006
RESPS:79 HOURS:1,575 COSTS(000):$0
Native Employment Works (NEW) Program Plan Guidance and Program
Report
FORMS: NONE
OMB NO: 0970-0175 EXPIRATION DATE: 07/31/2004
RESPS:6,905,480 HOURS:76,059 COSTS(000):$0
Voluntary Establishment of Paternity
FORMS: NONE
OMB NO: 0970-0177 EXPIRATION DATE: 06/30/2004
RESPS:54 HOURS:216 COSTS(000):$0
The OCSE-157 Child Support Enforcement Annual Data Report
FORMS: NONE
OMB NO: 0970-0181 EXPIRATION DATE: 09/30/2004
RESPS:432 HOURS:3,456 COSTS(000):$2,000
Child Support Enforcement Program Financial Report Child Support
Enforcement Program Quarterly Report of Collections
FORMS: OCSE-396A OCSE-34A
OMB NO: 0970-0183 EXPIRATION DATE: 01/31/2005
RESPS:144 HOURS:288 COSTS(000):$0
Project 1099
FORMS: NONE
OMB NO: 0970-0186 EXPIRATION DATE: 02/28/2005
RESPS:1 HOURS:15,552 COSTS(000):$0
Information Collection for the Methodology for Determining
Whether an Increase in a State's Child Poverty Rate Is the
Result of the TANF Program(s) in the State
FORMS: NONE
OMB NO: 0970-0193 EXPIRATION DATE: 01/31/2006
RESPS:200 HOURS:8,200 COSTS(000):$0
45 C.F.R. 1309 Head Start Grants Administration
FORMS: NONE
OMB NO: 0970-0195 EXPIRATION DATE: 03/31/2005
RESPS:232 HOURS:1,856 COSTS(000):$0
Child Care and Development Fund Annual Financial Report for
Tribes
FORMS: ACF-696T
OMB NO: 0970-0196 EXPIRATION DATE: 08/31/2004
RESPS:17,173 HOURS:8,586 COSTS(000):$157
Financial Institution Data Match
FORMS: NONE
OMB NO: 0970-0198 EXPIRATION DATE: 06/30/2005
RESPS:262 HOURS:4,978 COSTS(000):$0
Child Care and Development Fund Tribal Plan
FORMS: ACF-118-A
OMB NO: 0970-0199 EXPIRATION DATE: 04/30/2003
RESPS:208 HOURS:586,864 COSTS(000):$13,500
TANF Data Report (Includes TANF Sampling and Statistical Methods
Manual), SSP-MOE Data report (Includes TANF Sampling and
Statistical Methods Manual
FORMS: ACF-199 ACF-209
OMB NO: 0970-0202 EXPIRATION DATE: 09/30/2005
RESPS:15,839 HOURS:20,948 COSTS(000):$0
National Survey of Child and Adolescent Well-Being (Child
Welfare Longitudinal Study)
FORMS: NONE
OMB NO: 0970-0205 EXPIRATION DATE: 05/31/2004
RESPS:4 HOURS:5,200 COSTS(000):$0
IV-E Foster Care and Adoption Assistance Financial Report
FORMS: ACF-IV-E-1
OMB NO: 0970-0207 EXPIRATION DATE: 04/30/2003
RESPS:1,513 HOURS:49,929 COSTS(000):$998
Head Start Program Grant Application
FORMS: NONE
OMB NO: 0970-0209 EXPIRATION DATE: 01/31/2006
RESPS:972 HOURS:292 COSTS(000):$0
Online Interstate Referral Guide (IRG)
FORMS: NONE
OMB NO: 0970-0214 EXPIRATION DATE: 04/30/2003
RESPS:39 HOURS:17,621 COSTS(000):$0
Title IV-E Foster Care Eligibility Reviews, Child and Family
Services Reviews, Section 471(a)(18) Compliance Reviews
FORMS: NONE
OMB NO: 0970-0215 EXPIRATION DATE: 05/31/2003
RESPS:216 HOURS:68,544 COSTS(000):$198
Final Tribal TANF Data Report
FORMS: ACF-343
OMB NO: 0970-0218 EXPIRATION DATE: 09/30/2003
RESPS:990 HOURS:29,464 COSTS(000):$0
Tribal Child Support Enforcement Direct Funding Request and
Reports -- Notice of Proposed Rulemaking and Interim Final Rule
FORMS: NONE
OMB NO: 0970-0221 EXPIRATION DATE: 11/30/2003
RESPS:216 HOURS:216 COSTS(000):$0
State Systems Profiles
FORMS: NONE
OMB NO: 0970-0222 EXPIRATION DATE: 12/31/2003
RESPS:2,234 HOURS:120,653 COSTS(000):$22
National Medical Support Notice - Final Rule
FORMS: NONE
OMB NO: 0970-0223 EXPIRATION DATE: 01/31/2004
RESPS:54 HOURS:208,764 COSTS(000):$450
State Self-Assessemtn Review and Report
FORMS: NONE
OMB NO: 0970-0226 EXPIRATION DATE: 09/30/2004
RESPS:1,404 HOURS:975 COSTS(000):$0
Study of the TANF Application Process
FORMS: NONE
OMB NO: 0970-0228 EXPIRATION DATE: 09/30/2004
RESPS:540 HOURS:360 COSTS(000):$0
Assets for Independence Act (AFIA) Participant Survey
FORMS: NONE
OMB NO: 0970-0229 EXPIRATION DATE: 09/30/2005
RESPS:19,237 HOURS:13,745 COSTS(000):$0
Head Start Impact Study (HSIS)
FORMS: NONE
OMB NO: 0970-0230 EXPIRATION DATE: 07/31/2005
RESPS:108 HOURS:1,728 COSTS(000):$0
TANF High Performance Bonus for Fiscal Year 2002, Electronic
Transmission File Layouts and Federal System Edits on Work
Measures
FORMS: ACF-300
OMB NO: 0970-0232 EXPIRATION DATE: 03/31/2005
RESPS:264 HOURS:150 COSTS(000):$0
Tribal TANF (Temporary Assistance for Needy Families)
Experience: Problems, Solutions, and Lessons Learned
FORMS: NONE
OMB NO: 0970-0234 EXPIRATION DATE: 03/31/2005
RESPS:56 HOURS:6,160 COSTS(000):$157
Social Services Block Grant Post-Expenditure Report
FORMS: NONE
OMB NO: 0970-0238 EXPIRATION DATE: 06/30/2005
RESPS:195 HOURS:820 COSTS(000):$0
Emerging Practices in Child Abuse and Neglect Prevention
FORMS: NONE
OMB NO: 0970-0239 EXPIRATION DATE: 11/30/2005
RESPS:2 HOURS:45 COSTS(000):$0
Evaluation of the Early Head Start Fatherhood Demonstration
FORMS: NONE
OMB NO: 0970-0240 EXPIRATION DATE: 08/31/2003
RESPS:240 HOURS:240 COSTS(000):$0
Implementation of Promoting Safe and Stable Families by Indian
Tribes
FORMS: NONE
OMB NO: 0970-0242 EXPIRATION DATE: 09/30/2005
RESPS:4,025 HOURS:2,602 COSTS(000):$0
HHS/ACF Employment Retention and Advancement (ERA) Evaluation
12-Month Survey
FORMS: NONE
OMB NO: 0970-0245 EXPIRATION DATE: 02/28/2006
RESPS:52 HOURS:3,952 COSTS(000):$0
Court Improvement Program
FORMS: SF-424 424-A
OMB NO: 0970-0246 EXPIRATION DATE: 02/28/2006
RESPS:1,197 HOURS:1,016 COSTS(000):$0
Rural Welfare-to-Work Strategies Demonstration Evaluation Project
FORMS: NONE
OMB NO: 0970-0249 EXPIRATION DATE: 08/31/2003
RESPS:2,634 HOURS:3,584 COSTS(000):$0
Design and Field Testing of Head Start National Reporting System
on Child Outcomes
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
70 67,763,507 5,568,263 $104,801
Office of Human Development Services
OMB NO: 0980-0017 EXPIRATION DATE: 11/30/2004
RESPS:2,437 HOURS:9,748 COSTS(000):$0
Head Start Program Information Report
FORMS: NONE
OMB NO: 0980-0047 EXPIRATION DATE: 07/31/2005
RESPS:300 HOURS:112,500 COSTS(000):$0
Child and Family Services Plan (CFSP), Annual Progress and
Services Reprot (APSR), and Annual Budget Expenses Request and
Estimated Expenditures (CFS-101)
FORMS: CFS-101
OMB NO: 0980-0140 EXPIRATION DATE: 07/31/2004
RESPS:714,056 HOURS:1,872,392 COSTS(000):$0
Case Plan Requirements, Section 422(b); 471(a)(16), 475(5) and
475(6) of the Social Security Act (SSA); 45 CFR 1356.21(f)(g)
FORMS: NONE
OMB NO: 0980-0141 EXPIRATION DATE: 10/31/2005
RESPS:12 HOURS:180 COSTS(000):$0
State Plan for Title IV-E of the Social Security Act: Foster
Care, Independent Living Services and Adoption Assistance
FORMS: NONE
OMB NO: 0980-0160 EXPIRATION DATE: 08/31/2005
RESPS:57 HOURS:2,508 COSTS(000):$2
Developmental Disabilities Protection and Advocacy Program
Performance Report
FORMS: NONE
OMB NO: 0980-0162 EXPIRATION DATE: 09/30/2005
RESPS:1 HOURS:4,400 COSTS(000):$1,650
Developmental Disabilities State Plan
FORMS: NONE
OMB NO: 0980-0172 EXPIRATION DATE: 09/30/2005
RESPS:1 HOURS:2,420 COSTS(000):$2
State Council on Developmental Disabilities Program Performance
Report
FORMS: NONE
OMB NO: 0980-0196 EXPIRATION DATE: 04/30/2005
RESPS:52 HOURS:3,120 COSTS(000):$0
Application and Program Reporting Requirements for Children's
Justice Act Grants
FORMS: NONE
OMB NO: 0980-0204 EXPIRATION DATE: 04/30/2003
RESPS:650 HOURS:18,200 COSTS(000):$0
Program Narrative Objective Work Plan (OWP)
FORMS: NONE
OMB NO: 0980-0212 EXPIRATION DATE: 09/30/2005
RESPS:110 HOURS:990 COSTS(000):$0
Financial Status Reporting Form (SF-269) with Supplemental Form
(ADD-02) for porogam of state council on developmental
disabilities
FORMS: ADD02/SF269
OMB NO: 0980-0229 EXPIRATION DATE: 06/30/2003
RESPS:52 HOURS:4,780 COSTS(000):$63
National Child Abuse and Neglect Data System (NCANDS)
FORMS: NONE
OMB NO: 0980-0241 EXPIRATION DATE: 11/30/2004
RESPS:257 HOURS:8,995 COSTS(000):$0
Child Care and Development Fund Tribal Annual Report
FORMS: ACF-700
OMB NO: 0980-0243 EXPIRATION DATE: 01/31/2006
RESPS:2,500 HOURS:5,000 COSTS(000):$0
45 C.F.R. 1301 Head Start Grants Administration
FORMS: NONE
OMB NO: 0980-0266 EXPIRATION DATE: 08/31/2004
RESPS:1,505 HOURS:496 COSTS(000):$0
Voluntary Survey of Program Partners to implement Executive
Order 12862 within the Administration for Children Families
FORMS: NONE
OMB NO: 0980-0270 EXPIRATION DATE: 09/30/2003
RESPS:1 HOURS:2,508 COSTS(000):$2
Developmental Disabilities Protection and Advocacy Statement of
Goals and Priorities
FORMS: NONE
OMB NO: 0980-0271 EXPIRATION DATE: 10/31/2004
RESPS:4,021,364 HOURS:221,325 COSTS(000):$259
Computerized Support Enforcement Systems - Final Rule
FORMS: NONE
OMB NO: 0980-0272 EXPIRATION DATE: 06/30/2003
RESPS:560 HOURS:31,120 COSTS(000):$0
Child Welfare Demonstration Project Information Collection
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
17 4,743,915 2,300,682 $1,978
Administration on Aging
OMB NO: 0985-0004 EXPIRATION DATE: 08/31/2004
RESPS:112 HOURS:112 COSTS(000):$1,426
Supplemental Form to the Financial Status Report (SF269), Title
III of the Older Americans Act, Grants for State and Community
Programs on Aging
FORMS: NONE
OMB NO: 0985-0005 EXPIRATION DATE: 12/31/2005
RESPS:52 HOURS:7,620 COSTS(000):$58,068
State Annual Long-Term Care Ombudsman Report
FORMS: NONE
OMB NO: 0985-0006 EXPIRATION DATE: 08/31/2004
RESPS:398 HOURS:7,960 COSTS(000):$0
Performance Progress Reports for Title IV Grantees
FORMS: NONE
OMB NO: 0985-0007 EXPIRATION DATE: 07/31/2003
RESPS:2 HOURS:681 COSTS(000):$0
Program Performance Report, Title VI of the Older Americans Act.
(Grants for Native Americans for Nutritional and Supportive
Services)
FORMS: NONE
OMB NO: 0985-0008 EXPIRATION DATE: 01/31/2006
RESPS:1 HOURS:141,132 COSTS(000):$0
State Program Report for Title III and VII of the Older
Americans Act
FORMS: NONE
OMB NO: 0985-0009 EXPIRATION DATE: 07/31/2005
RESPS:56 HOURS:28 COSTS(000):$748
Certification of Maintenance of Effort
FORMS: NONE
OMB NO: 0985-0012 EXPIRATION DATE: 02/28/2005
RESPS:50 HOURS:1,000 COSTS(000):$0
Alzheimer's Disease Demonstration Grants to States Program
Semi-Annual Report and Instructions
FORMS: NONE
OMB NO: 0985-0013 EXPIRATION DATE: 02/28/2005
RESPS:9,250 HOURS:1,713 COSTS(000):$0
Alzheimer's Disease Demonstration Grants to States Program
Evaluation Data Collection
FORMS: NONE
OMB NO: 0985-0014 EXPIRATION DATE: 05/31/2003
RESPS:3,708 HOURS:2,046 COSTS(000):$0
National Survey of Older American Act Participants
FORMS: NONE
OMB NO: 0985-0015 EXPIRATION DATE: 09/30/2003
RESPS:1,600 HOURS:267 COSTS(000):$0
National Family Caregiver Support Program Survey: Grandparents
and Other Relatives Raising Children
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
10 15,229 162,559 $60,242
Departmental Management
OMB NO: 0990-0001 EXPIRATION DATE: 04/30/2003
RESPS:200 HOURS:1,200 COSTS(000):$150
Application for Waiver of the 2-Year Foreign Residence
Requirement of the Exchange Visitor Program
FORMS: HHS-426
OMB NO: 0990-0115 EXPIRATION DATE: 09/30/2004
RESPS:4,269 HOURS:986,280 COSTS(000):$0
Procurement - Solicitation and Contracts
FORMS: NONE
OMB NO: 0990-0124 EXPIRATION DATE: 05/31/2004
RESPS:2,600 HOURS:41,600 COSTS(000):$0
Self-Evaluation & Recordkeeping Required by Regulations
Implementing Section 504 of the Rehabilitation Act of 1973
FORMS: NONE
OMB NO: 0990-0128 EXPIRATION DATE: 05/31/2004
RESPS:122 HOURS:1,102 COSTS(000):$0
HHS Acquisition Regulations: HHSAR Section 352.270-9 and Section
252.223-70
FORMS: NONE
OMB NO: 0990-0129 EXPIRATION DATE: 01/31/2006
RESPS:1,242 HOURS:10,556 COSTS(000):$0
Special Programs Affecting Acquisiiton (HHSAR Part 370)
FORMS: NONE
OMB NO: 0990-0130 EXPIRATION DATE: 01/31/2006
RESPS:1,921 HOURS:3,842 COSTS(000):$0
Solicitation Provisions and Contract Clauses (HHSAR Part 352)
FORMS: NONE
OMB NO: 0990-0131 EXPIRATION DATE: 12/31/2005
RESPS:110 HOURS:2,200 COSTS(000):$0
HHS Acquisition Regulation - HHSAR Part 342 - Contract
Administration
FORMS: NONE
OMB NO: 0990-0133 EXPIRATION DATE: 12/31/2005
RESPS:80 HOURS:40 COSTS(000):$0
HHS Acquisition Regulation - HHSAR Part 333 - Disputes and
Appeals
FORMS: NONE
OMB NO: 0990-0136 EXPIRATION DATE: 01/31/2006
RESPS:430 HOURS:3,440 COSTS(000):$0
HHS Acquisition Regulation - HHSAR Part 324 - Protection of
Privacy and Freedom of Information
FORMS: NONE
OMB NO: 0990-0139 EXPIRATION DATE: 06/30/2003
RESPS:6,645 HOURS:13,290 COSTS(000):$0
HHS Acquisition Regulation - HHSAR Subpart 315.4 - Solicitation
and Receipt of Proposals and Quotations
FORMS: NONE
OMB NO: 0990-0150 EXPIRATION DATE: 04/30/2004
RESPS:1 HOURS:1 COSTS(000):$0
Uniform Relocation and Real Property Acquisition Under Federal
and Federally Assisted Program
FORMS: NONE
OMB NO: 0990-0169 EXPIRATION DATE: 12/31/2005
RESPS:4,000 HOURS:280,000 COSTS(000):$0
Uniform Administrative Requirements for Grantrs and Cooperative
Agreements to State and Local Governments
FORMS: NONE
OMB NO: 0990-0208 EXPIRATION DATE: 03/31/2004
RESPS:30,000 HOURS:10,333 COSTS(000):$0
Applicant Background Survey
FORMS: NONE
OMB NO: 0990-0220 EXPIRATION DATE: 12/31/2003
RESPS:2,400 HOURS:480 COSTS(000):$0
Voluntary Industry Partner Surveys to Implement E.O. 12862
FORMS: NONE
OMB NO: 0990-0221 EXPIRATION DATE: 09/30/2004
RESPS:85 HOURS:1,870 COSTS(000):$47
Title X Family Planning Annual Report
FORMS: NONE
OMB NO: 0990-0223 EXPIRATION DATE: 12/31/2003
RESPS:7,350 HOURS:3,496 COSTS(000):$0
Evaluation of the Cash and Counseling Demonstration
FORMS: NONE
OMB NO: 0990-0230 EXPIRATION DATE: 06/30/2003
RESPS:780 HOURS:930 COSTS(000):$0
Site Visit Protocols for the Multi-site Evaluation of the
Welfare-to-Work Grants Program
FORMS: NONE
OMB NO: 0990-0232 EXPIRATION DATE: 10/31/2003
RESPS:1,157 HOURS:503 COSTS(000):$0
Cash and Counseling Demonstration--Additional Survey Instruments
FORMS: NONE
OMB NO: 0990-0236 EXPIRATION DATE: 02/29/2004
RESPS:620 HOURS:620 COSTS(000):$0
Financial Summary of Obligation and Expenditure of Block Grant
Funds (45 CFR 96.30)
FORMS: SF-269A
OMB NO: 0990-0237 EXPIRATION DATE: 05/31/2003
RESPS:7,220 HOURS:6,138 COSTS(000):$0
First Follow-up Survey of Youth - Federal Evaluation of
Initiatives Funded Under Section 510 of the Maternal and Child
Health Block Grant Program
FORMS: NONE
OMB NO: 0990-0238 EXPIRATION DATE: 06/30/2003
RESPS:12,750 HOURS:9,819 COSTS(000):$0
Follow-up Survey for the Multi-site Evaluation of the
Welfare-to-Work Grants Program
FORMS: NONE
OMB NO: 0990-0239 EXPIRATION DATE: 06/30/2003
RESPS:136 HOURS:46 COSTS(000):$0
Empowerment Zone and Enterprise Community Health Improvement
Capacity Survey
FORMS: NONE
OMB NO: 0990-0240 EXPIRATION DATE: 07/31/2003
RESPS:3,555 HOURS:666 COSTS(000):$0
Survey of Grant Recipients
FORMS: NONE
OMB NO: 0990-0243 EXPIRATION DATE: 10/31/2003
RESPS:3,000 HOURS:48,000 COSTS(000):$0
OCR Pre-grant Automation Project
FORMS: NONE
OMB NO: 0990-0244 EXPIRATION DATE: 03/31/2004
RESPS:3,000 HOURS:1,000 COSTS(000):$0
National Centers of Excellence in Women's Health Program
Quantitative Evaluation Survey
FORMS: NONE
OMB NO: 0990-0250 EXPIRATION DATE: 10/31/2004
RESPS:600 HOURS:150 COSTS(000):$0
National Centers of Excellence in Women's Health Program
Supplemental Quantiative Community Survey
FORMS: NONE
OMB NO: 0990-0253 EXPIRATION DATE: 06/30/2004
RESPS:1,104 HOURS:1,288 COSTS(000):$0
National Study of Child Protective Services Systems and Reform
Efforts
FORMS: NONE
OMB NO: 0990-0255 EXPIRATION DATE: 06/30/2003
RESPS:720 HOURS:300 COSTS(000):$0
National Study of Culturally and Linguistically Appropriate
Services in Managed Care Organization
FORMS: NONE
OMB NO: 0990-0256 EXPIRATION DATE: 02/28/2005
RESPS:21,600 HOURS:12,744 COSTS(000):$0
Survey of SCHIP Enrollees and Disenrollees for the
Congressionally Mandated Evaluation of the State Children's
Health Insurance Program
FORMS: NONE
OMB NO: 0990-0257 EXPIRATION DATE: 05/31/2005
RESPS:2,872 HOURS:1,436 COSTS(000):$0
Wave Three Survey of Youth for the Evaluation of Initiatives
Funded Under Section 510 of the Maternal & Child Health Block
Grant
FORMS: NONE
OMB NO: 0990-0258 EXPIRATION DATE: 05/31/2005
RESPS:2,044 HOURS:1,515 COSTS(000):$0
A Study of Stroke Post-Acute Care Outcomes
FORMS: NONE
OMB NO: 0990-0260 EXPIRATION DATE: 05/31/2005
RESPS:88,566 HOURS:194,376 COSTS(000):$0
Protection of Human Subjects: Common Rule (56 FR 28003)
FORMS: NONE
OMB NO: 0990-0262 EXPIRATION DATE: 06/30/2003
RESPS:1 HOURS:1,250 COSTS(000):$0
Survey of Research Integrity Measures Utilized in Biomedical
Research Laboratories
FORMS: NONE
OMB NO: 0990-0263 EXPIRATION DATE: 07/31/2005
RESPS:17,000 HOURS:1 COSTS(000):$0
Protection of Human Subjects Assurance Identification/IRB
Certification/Declaration of Exemption
FORMS: NONE
OMB NO: 0990-0264 EXPIRATION DATE: 06/30/2005
RESPS:6,640 HOURS:4,378 COSTS(000):$0
State Studies on TANF Caseload
FORMS: NONE
OMB NO: 0990-0265 EXPIRATION DATE: 12/31/2003
RESPS:120 HOURS:480 COSTS(000):$0
Assessment of State Laws, Regulations, and Practice Affecting
the Collection and Reporting of Racial/Ethnic Health Data
FORMS: NONE
OMB NO: 0990-0267 EXPIRATION DATE: 02/28/2006
RESPS:1,252 HOURS:1,138 COSTS(000):$0
Study of Fathers' Involvement in Permanency Planning and Child
Welfare Casework
FORMS: NONE
OMB NO: 0990-0268 EXPIRATION DATE: 09/30/2005
RESPS:6,755 HOURS:3,720 COSTS(000):$0
Service Use and Transition of Private Long-term Care Insurance
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
38 242,947 1,650,228 $197
Office of Family Assistance
OMB NO: 0992-0005 EXPIRATION DATE: 05/31/2003
RESPS:260 HOURS:5,752 COSTS(000):$0
45 CFR Part 95, Subpart F -- Automatic Data Processing Equipment
and Services--Conditions for Federal Financial Participation
FORMS: NONE
OMB NO: 0992-0007 EXPIRATION DATE: 07/31/2004
RESPS:216 HOURS:4,320 COSTS(000):$0
TANF High Performance Bonus Report, Assessment of Medicaid and
SCHIP Enrollment Among Individuals After Leaving TANF Assistance
FORMS: ACF-210
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
2 476 10,072 $0
AGENCY TOTALS:
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
828 3,003,402,939 231,714,026 $1,285,272
Department of Homeland Security
Bureau of Citizenship and Immigration Services
OMB NO: 1615-0001 EXPIRATION DATE: 11/30/2004
RESPS:200,000 HOURS:100,000 COSTS(000):$19,000
Petition for Alien Fiance(e)
FORMS: I-129F
OMB NO: 1615-0002 EXPIRATION DATE: 11/30/2005
RESPS:400,000 HOURS:400,000 COSTS(000):$126,000
LIFE Legalization Supplement to Form I-485 Instructions
FORMS: I-485
OMB NO: 1615-0003 EXPIRATION DATE: 07/31/2004
RESPS:683,210 HOURS:512,407 COSTS(000):$81,985
Application to Extend/Change Nonimmigrant Status
FORMS: I-539
OMB NO: 1615-0004 EXPIRATION DATE: 11/30/2004
RESPS:427,000 HOURS:213,500 COSTS(000):$0
Supplement A to form I-539 (Filing Instructions for V
Nonimmigrant Status)
FORMS: I-539-SUPP.A
OMB NO: 1615-0005 EXPIRATION DATE: 11/30/2004
RESPS:40,000 HOURS:100,000 COSTS(000):$6,600
Application for Benefits Under the Family Unity Program
FORMS: I-817
OMB NO: 1615-0006 EXPIRATION DATE: 04/30/2003
RESPS:15,000 HOURS:16,200 COSTS(000):$5,250
Checklist for On-Site Review of Schools
FORMS: NONE
OMB NO: 1615-0007 EXPIRATION DATE: 10/31/2004
RESPS:250,000 HOURS:20,750 COSTS(000):$0
Alien Change of Address Card
FORMS: AR-11
OMB NO: 1615-0008 EXPIRATION DATE: 01/31/2005
RESPS:1,144,994 HOURS:286,249 COSTS(000):$0
Biographic Information
FORMS: G-325
OMB NO: 1615-0009 EXPIRATION DATE: 06/30/2003
RESPS:368,948 HOURS:1,014,607 COSTS(000):$168,676
Petition for Nonimmigrant Worker
FORMS: I-129
OMB NO: 1615-0010 EXPIRATION DATE: 09/30/2005
RESPS:250,000 HOURS:145,750 COSTS(000):$0
Nonimmigrant Petition Based on Blanket L Petition
FORMS: I-129S
OMB NO: 1615-0011 EXPIRATION DATE: 02/28/2006
RESPS:64,046 HOURS:64,046 COSTS(000):$128,092
H-1B Data Collection and Filing Fee Exemption
FORMS: I-129W
OMB NO: 1615-0012 EXPIRATION DATE: 05/31/2003
RESPS:506,358 HOURS:253,179 COSTS(000):$0
Petition for Alien relative
FORMS: I-130
OMB NO: 1615-0013 EXPIRATION DATE: 06/30/2004
RESPS:453,318 HOURS:407,986 COSTS(000):$43,065
Application for Travel Document
FORMS: I-131
OMB NO: 1615-0014 EXPIRATION DATE: 06/30/2003
RESPS:44,000 HOURS:14,652 COSTS(000):$0
Affidavit of Support
FORMS: I-134
OMB NO: 1615-0015 EXPIRATION DATE: 08/31/2004
RESPS:96,000 HOURS:96,000 COSTS(000):$11,040
Immigrant Petition for Alien Workers
FORMS: I-140
OMB NO: 1615-0016 EXPIRATION DATE: 06/30/2003
RESPS:300 HOURS:75 COSTS(000):$51
Application for Advance Permission to Return to Unrelinquished
Domicile
FORMS: I-191
OMB NO: 1615-0017 EXPIRATION DATE: 01/31/2005
RESPS:12,000 HOURS:3,000 COSTS(000):$2,040
Application for Advance Permission to Enter as Nonimmigrant
(Pusuant to 212(d)(3) of the Immigration and Nationality Act)
FORMS: FORM-I-192
OMB NO: 1615-0018 EXPIRATION DATE: 11/30/2005
RESPS:4,200 HOURS:8,400 COSTS(000):$819
Application for Permission to reapply for Admission into the
United States after Deportation or Removal
FORMS: I-212
OMB NO: 1615-0019 EXPIRATION DATE: 02/28/2005
RESPS:41 HOURS:7 COSTS(000):$0
Application for Removal
FORMS: I-243
OMB NO: 1615-0020 EXPIRATION DATE: 02/28/2005
RESPS:8,397 HOURS:16,794 COSTS(000):$1,071
Petition ofr Amerasian, Widow or Special Immigrant
FORMS: I-360
OMB NO: 1615-0021 EXPIRATION DATE: 12/31/2005
RESPS:50 HOURS:25 COSTS(000):$0
Affidavit of Financial Support and Intent to Petition for Legal
Custody for Public Law 97-359 Amerasian
FORMS: I-361
OMB NO: 1615-0022 EXPIRATION DATE: 10/31/2004
RESPS:50 HOURS:25 COSTS(000):$0
Request to Enforce Affidavit of Financial Support and Intent to
Petition for custody for Pub.L. 97-359 Amerasian
FORMS: I-363
OMB NO: 1615-0023 EXPIRATION DATE: 05/31/2005
RESPS:635,500 HOURS:2,781,321 COSTS(000):$193,256
Application to Register Permanent Residence or Adjust Status,
and Supplement A to Form I-485
FORMS: I-485 SUPP.A-I-485
OMB NO: 1615-0024 EXPIRATION DATE: 12/31/2005
RESPS:50,000 HOURS:25,000 COSTS(000):$0
HRIFA Supplement to Form I-485 Instructions
FORMS: I-485-SUPP.C
OMB NO: 1615-0025 EXPIRATION DATE: 06/30/2005
RESPS:1,800 HOURS:150 COSTS(000):$0
Waiver of Rights, Privileges, Exemptions and Immunities
FORMS: I-508
OMB NO: 1615-0026 EXPIRATION DATE: 02/28/2005
RESPS:1,368 HOURS:1,710 COSTS(000):$547
Immigrant Petition by Alien Entrepreneur
FORMS: I-526
OMB NO: 1615-0027 EXPIRATION DATE: 05/31/2003
RESPS:4,400 HOURS:1,100 COSTS(000):$0
Inter-Agency Record of Individual Requesting Change/Adjustment
to or form A or g Status; or Requesting A, G. or NATO Dependent
Employment Authorization
FORMS: I-566
OMB NO: 1615-0028 EXPIRATION DATE: 06/30/2005
RESPS:34,000 HOURS:17,000 COSTS(000):$15,640
Petition to Classify Orphan as an Immediate Relative and
Application for Advance Processing of Orphan Petition
FORMS: I-600 I-600A
OMB NO: 1615-0029 EXPIRATION DATE: 06/30/2003
RESPS:3,000 HOURS:1,500 COSTS(000):$510
Application for Waiver of Ground of Excludability
FORMS: I-601
OMB NO: 1615-0030 EXPIRATION DATE: 06/30/2005
RESPS:1,300 HOURS:432 COSTS(000):$253
Application for Waiver of the Foreign Residence Requirement of
Section 212(e) of the Immigration and Nationality Act
FORMS: I-612
OMB NO: 1615-0031 EXPIRATION DATE: 07/31/2005
RESPS:3,000 HOURS:249 COSTS(000):$0
Supplementary Statement for Graduate Medical Trainees
FORMS: I-644
OMB NO: 1615-0032 EXPIRATION DATE: 09/30/2005
RESPS:85 HOURS:21 COSTS(000):$3
Application for Waiver of Grounds of Excludability
FORMS: I-690
OMB NO: 1615-0033 EXPIRATION DATE: 04/30/2005
RESPS:800,000 HOURS:1,200,000 COSTS(000):$0
Medical Examination of Aliens Seeking Adjustment of Status
FORMS: I-693
OMB NO: 1615-0034 EXPIRATION DATE: 06/30/2005
RESPS:1,192 HOURS:596 COSTS(000):$60
Notice of Appeal of Decision Under Section 210 or 245A of the
Immigration and Nationality Act
FORMS: I-694
OMB NO: 1615-0035 EXPIRATION DATE: 11/30/2004
RESPS:1,179 HOURS:1,179 COSTS(000):$141
Application to Adjust Status from Temporary to Permanent Resident
FORMS: I-698
OMB NO: 1615-0036 EXPIRATION DATE: 12/31/2005
RESPS:100,000 HOURS:16,600 COSTS(000):$0
Certificate of Satisfactory Pursuit
FORMS: I-699
OMB NO: 1615-0037 EXPIRATION DATE: 04/30/2005
RESPS:86,400 HOURS:50,371 COSTS(000):$0
Refugee/Asylee Relative Position
FORMS: I-730
OMB NO: 1615-0038 EXPIRATION DATE: 01/31/2005
RESPS:118,008 HOURS:156,951 COSTS(000):$17,111
Petition to Remove the Conditions on Residence
FORMS: I-751
OMB NO: 1615-0039 EXPIRATION DATE: 06/30/2005
RESPS:5 HOURS:1 COSTS(000):$0
Guam Visa Waiver Agreement
FORMS: I-760
OMB NO: 1615-0040 EXPIRATION DATE: 04/30/2005
RESPS:1,873,296 HOURS:4,083,785 COSTS(000):$224,795
Application for Employment Authorization
FORMS: FORM-I-765
OMB NO: 1615-0041 EXPIRATION DATE: 06/30/2003
RESPS:15,000 HOURS:26,250 COSTS(000):$0
Liberian Deferred Enforced Departure (DED) Supplement to Form
I-765
FORMS: I-765D
OMB NO: 1615-0042 EXPIRATION DATE: 03/31/2004
RESPS:100 HOURS:50 COSTS(000):$2
Application for Issuance or Replacement of Nothern Mariana Card
FORMS: I-777
OMB NO: 1615-0043 EXPIRATION DATE: 03/31/2004
RESPS:181,000 HOURS:90,500 COSTS(000):$8,800
Application for Temporary Protected Status
FORMS: I-821 I-821A
OMB NO: 1615-0044 EXPIRATION DATE: 03/31/2004
RESPS:43,772 HOURS:18,209 COSTS(000):$5,253
Application for Action on an Approved Application or Petition
FORMS: I-824
OMB NO: 1615-0045 EXPIRATION DATE: 12/31/2005
RESPS:200 HOURS:216 COSTS(000):$79
Petition by Entrepreneur to Remove Conditions
FORMS: I-829
OMB NO: 1615-0046 EXPIRATION DATE: 09/30/2005
RESPS:125 HOURS:531 COSTS(000):$0
Interagency Alien Witness and Informant Record
FORMS: I-854
OMB NO: 1615-0047 EXPIRATION DATE: 11/30/2003
RESPS:78,000,000 HOURS:13,020,000 COSTS(000):$0
Employment Eligibility Verification
FORMS: I-9
OMB NO: 1615-0048 EXPIRATION DATE: 01/31/2005
RESPS:80,000 HOURS:40,000 COSTS(000):$8,000
Request for Premium Processing Service
FORMS: I-907
OMB NO: 1615-0049 EXPIRATION DATE: 12/31/2005
RESPS:1,000 HOURS:250 COSTS(000):$0
Request for Verification of Naturalization
FORMS: N-25
OMB NO: 1615-0050 EXPIRATION DATE: 07/31/2005
RESPS:7,669 HOURS:21,090 COSTS(000):$1,495
Request for Hearing on a Decision in Naturalization Proceedings
Under Section 336
FORMS: N-336
OMB NO: 1615-0051 EXPIRATION DATE: 02/28/2006
RESPS:1,920 HOURS:960 COSTS(000):$0
Monthly Report Naturalization Papers
FORMS: N-4
OMB NO: 1615-0052 EXPIRATION DATE: 07/31/2005
RESPS:700,000 HOURS:4,291,000 COSTS(000):$182,000
Application for Naturalization
FORMS: N-400
OMB NO: 1615-0053 EXPIRATION DATE: 02/29/2004
RESPS:45,000 HOURS:33,750 COSTS(000):$0
Request for Certification of Military or Naval Service
FORMS: N-426
OMB NO: 1615-0054 EXPIRATION DATE: 10/31/2005
RESPS:650,000 HOURS:53,950 COSTS(000):$0
Notice of Naturalization Oath Ceremony
FORMS: N-445
OMB NO: 1615-0055 EXPIRATION DATE: 07/31/2005
RESPS:100 HOURS:17 COSTS(000):$9
Application for Transfer of Petition for Naturalization
FORMS: N-455
OMB NO: 1615-0056 EXPIRATION DATE: 08/31/2003
RESPS:375 HOURS:375 COSTS(000):$43
Application to Preserve Residence for Naturalization
FORMS: N-470
OMB NO: 1615-0057 EXPIRATION DATE: 07/31/2005
RESPS:88,500 HOURS:88,500 COSTS(000):$15,932
Application for Certificate of Citizenship
FORMS: N-600
OMB NO: 1615-0058 EXPIRATION DATE: 06/30/2003
RESPS:11,159 HOURS:11,159 COSTS(000):$1,395
Application for Certificate of Citizenship in Behalf of an
Adopted Child
FORMS: N-643
OMB NO: 1615-0059 EXPIRATION DATE: 02/28/2006
RESPS:50 HOURS:92 COSTS(000):$4
Application for Posthumous Citizenship
FORMS: N-644
OMB NO: 1615-0060 EXPIRATION DATE: 03/31/2005
RESPS:20,000 HOURS:40,000 COSTS(000):$1,600
Medical Certification for Disability Exceptions
FORMS: N-648
OMB NO: 1615-0061 EXPIRATION DATE: 07/31/2005
RESPS:50 HOURS:2,000 COSTS(000):$0
Notice of Immigration Pilot Program
FORMS: NONE
OMB NO: 1615-0062 EXPIRATION DATE: 09/30/2005
RESPS:21,000 HOURS:37,240 COSTS(000):$4,550
Certificates for Health Care Benefits
FORMS: NONE
OMB NO: 1615-0063 EXPIRATION DATE: 03/31/2004
RESPS:8,000 HOURS:8,000 COSTS(000):$3,240
National Interest Waivers; Supplemental Evidence to I-140 and
I-485
FORMS: NONE
OMB NO: 1615-0064 EXPIRATION DATE: 05/31/2005
RESPS:100 HOURS:200 COSTS(000):$0
Special Immigrant Visas for Fourth Preference Employment-Based
Broadcasters
FORMS: NONE
OMB NO: 1615-0065 EXPIRATION DATE: 12/31/2004
RESPS:2,000 HOURS:4,000 COSTS(000):$0
Petitioning Requirements for H-1C Nonimmigrant Classification
FORMS: NONE
OMB NO: 1615-0066 EXPIRATION DATE: 01/31/2004
RESPS:5 HOURS:1,040,850 COSTS(000):$0
The Student and Exchange Visitor Information System (SEVIS)
FORMS: NONE
OMB NO: 1615-0067 EXPIRATION DATE: 04/30/2003
RESPS:78,000 HOURS:936,000 COSTS(000):$780
Application for Asylum and for Withholding of Removal
FORMS: I-589
OMB NO: 1615-0068 EXPIRATION DATE: 10/31/2005
RESPS:140,000 HOURS:81,620 COSTS(000):$0
Registration for Classification as a Refugee
FORMS: FORM-I-590
OMB NO: 1615-0069 EXPIRATION DATE: 07/31/2005
RESPS:2,500 HOURS:625 COSTS(000):$0
Application by Refugee for Waiver of Grounds of Excludability
FORMS: I-602
OMB NO: 1615-0070 EXPIRATION DATE: 01/31/2004
RESPS:195,000 HOURS:32,370 COSTS(000):$0
Health and Human Services Statistical Data for Refugee/Asylee
Adjusting Status
FORMS: I-643
OMB NO: 1615-0071 EXPIRATION DATE: 10/31/2005
RESPS:5,000 HOURS:2,500 COSTS(000):$0
ABC Change of Address Form and Special Filing Instructions for
ABC Class Members
FORMS: I-855 M-426
OMB NO: 1615-0072 EXPIRATION DATE: 02/28/2006
RESPS:55,000 HOURS:660,000 COSTS(000):$11,825
Application for Suspension of Deportation or Special Rule
Cancellation of Removal (Pursuant to Sec. 203 of Pub. L. 105-100)
FORMS: I-881
OMB NO: 1615-0073 EXPIRATION DATE: 07/31/2005
RESPS:20 HOURS:1,600 COSTS(000):$0
Guidelines on Producing Master Exhibits for Asylum Applications
FORMS: NONE
OMB NO: 1615-0074 EXPIRATION DATE: 04/30/2003
RESPS:12 HOURS:51,960 COSTS(000):$0
Contacts Concerning Project Speak Out!
FORMS: G-1046
OMB NO: 1615-0075 EXPIRATION DATE: 08/31/2004
RESPS:950,300 HOURS:2,443,350 COSTS(000):$0
Affidavit of Support Under Sction 213A of the Act, and Contract
Between Sponsor and Household Member
FORMS: I-864
OMB NO: 1615-0076 EXPIRATION DATE: 08/31/2004
RESPS:100,000 HOURS:23,300 COSTS(000):$0
Sponsor's Notice of Change of Address
FORMS: I-865
OMB NO: 1615-0077 EXPIRATION DATE: 04/30/2004
RESPS:150,000 HOURS:75,000 COSTS(000):$0
Generic Clearance of Customer Service Surveys (PREMIUM
PROCESSING SURVEY)
FORMS: OMB-9
OMB NO: 1615-0078 EXPIRATION DATE: 02/29/2004
RESPS:433 HOURS:325 COSTS(000):$21
Application to File Declaration of Intention
FORMS: N-300
OMB NO: 1615-0079 EXPIRATION DATE: 02/29/2004
RESPS:20,000 HOURS:5,073 COSTS(000):$1,700
Application for Replacement/Initial Nonimmigrant Arrival-
Departure Document
FORMS: I-102
OMB NO: 1615-0080 EXPIRATION DATE: 01/31/2006
RESPS:1,000,000 HOURS:75,000 COSTS(000):$0
INS Case Status Online
FORMS: NONE
OMB NO: 1615-0081 EXPIRATION DATE: 06/30/2003
RESPS:5,000 HOURS:2,500 COSTS(000):$0
Application Requirements for the Adjustment of Status Under
Section 586 of Public Law 106-249
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
81 91,260,835 35,232,030 $1,292,733
U.S. Secret Service
OMB NO: 1620-0001 EXPIRATION DATE: 05/31/2003
RESPS:7,500 HOURS:22,500 COSTS(000):$0
Supplemental Investigative Data
FORMS: SSF86A
OMB NO: 1620-0002 EXPIRATION DATE: 08/31/2003
RESPS:5,000 HOURS:1,250 COSTS(000):$0
Contractor Personnel Access Application
FORMS: SSF-3237
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
2 12,500 23,750 $0
U.S. Coast Guard
OMB NO: 1625-0001 EXPIRATION DATE: 01/31/2005
RESPS:181,089 HOURS:19,195 COSTS(000):$0
Marine Casualty Information; Chemical Drug and Alcohol Testing
of Commercial Vessel Personnel; and Management Information
System Requirements
FORMS: CG-2692 CG-2692A CG-2692B CG-5573
OMB NO: 1625-0002 EXPIRATION DATE: 08/31/2003
RESPS:2,443 HOURS:613 COSTS(000):$0
Application for Vessel Inspection and Waiver
FORMS: CG-2633 CG-3752
OMB NO: 1625-0003 EXPIRATION DATE: 06/30/2003
RESPS:8,000 HOURS:4,000 COSTS(000):$0
Recreational Boating Accident Report
FORMS: CG-3865
OMB NO: 1625-0004 EXPIRATION DATE: 02/29/2004
RESPS:13,600 HOURS:6,640 COSTS(000):$0
U.S. Coast Guard Academy Preliminary Application and
Supplemental Forms
FORMS: NONE
OMB NO: 1625-0005 EXPIRATION DATE: 04/30/2005
RESPS:265 HOURS:292 COSTS(000):$0
Application and Permit to Handle Hazardous Material
FORMS: CG-4260
OMB NO: 1625-0006 EXPIRATION DATE: 10/31/2004
RESPS:12,000 HOURS:18,000 COSTS(000):$0
Shipping Articles
FORMS: CG-705A
OMB NO: 1625-0007 EXPIRATION DATE: 01/31/2004
RESPS:43 HOURS:129 COSTS(000):$0
Characteristics of Liquid Chemicals Proposed for Bulk Water
Movement
FORMS: CG-4355
OMB NO: 1625-0008 EXPIRATION DATE: 08/31/2003
RESPS:1,500 HOURS:1,540 COSTS(000):$0
Regattas and Marine Parades
FORMS: NONE
OMB NO: 1625-0009 EXPIRATION DATE: 08/31/2003
RESPS:1,697 HOURS:35,828 COSTS(000):$0
Oil Record Book for Ships
FORMS: CG-4602A
OMB NO: 1625-0010 EXPIRATION DATE: 12/31/2005
RESPS:4 HOURS:328 COSTS(000):$0
Defect/Noncompliance Report and Campaign Update Report
FORMS: 4917 4918
OMB NO: 1625-0011 EXPIRATION DATE: 07/31/2005
RESPS:1 HOURS:3,073 COSTS(000):$0
CG-2554 Private Aids to Navigation Application. CG-4143
Application for Class I Private Aids to Nav artificial
islands/fixed structures
FORMS: CG-2554 CG-4143
OMB NO: 1625-0012 EXPIRATION DATE: 07/31/2003
RESPS:130,000 HOURS:4,500 COSTS(000):$0
Certificate of Discharge to Merchant Mariners
FORMS: CG-718A
OMB NO: 1625-0013 EXPIRATION DATE: 05/31/2005
RESPS:20,495 HOURS:1,979 COSTS(000):$0
Plan Approval and Records for Load Lines
FORMS: 98-USA-LL A21-HSSC-LL- EXEMPT LL-14-A LL-18-E LL-40-A LL-19
LL-13-C LL-18-F
OMB NO: 1625-0014 EXPIRATION DATE: 08/31/2003
RESPS:29 HOURS:29 COSTS(000):$0
Request for Designation and Exemption of Oceanographic Research
Vessels
FORMS: NONE
OMB NO: 1625-0015 EXPIRATION DATE: 09/30/2005
RESPS:100 HOURS:4,000 COSTS(000):$0
Bridge Permit Application Guide; (BPAG)
FORMS: P16591.3B
OMB NO: 1625-0016 EXPIRATION DATE: 11/30/2004
RESPS:518 HOURS:226 COSTS(000):$0
Welding and Hot Work Permits; Posting of Warning Signs
FORMS: CG-4201
OMB NO: 1625-0017 EXPIRATION DATE: 11/30/2003
RESPS:458 HOURS:38 COSTS(000):$0
Various International Agreement Safety Certificates and Documents
FORMS: CG-967 CG-968 CG-968A CG-969 CG-3347 CG-3347B CG-4359 CG-5643
CG-5679 CG-5679A
OMB NO: 1625-0018 EXPIRATION DATE: 08/31/2005
RESPS:1,750 HOURS:1,750 COSTS(000):$0
Official Logbook
FORMS: 706B
OMB NO: 1625-0019 EXPIRATION DATE: 09/30/2004
RESPS:34 HOURS:153 COSTS(000):$0
Alternative Compliance for International and Inland Navigation
Rules -- 33 CFR Parts 81 and 89
FORMS: NONE
OMB NO: 1625-0020 EXPIRATION DATE: 01/31/2005
RESPS:333 HOURS:417 COSTS(000):$0
Security Zones, Regulated Navigation Areas, and Safety Zones
FORMS: NONE
OMB NO: 1625-0021 EXPIRATION DATE: 03/31/2005
RESPS:1,012 HOURS:27,369 COSTS(000):$0
Operations Manual and Amendments for Facilities Transferring Oil
and Hazardous Materials in Bulk
FORMS: NONE
OMB NO: 1625-0022 EXPIRATION DATE: 04/30/2003
RESPS:12,720 HOURS:27,600 COSTS(000):$0
Application for Tonnage Measurement of Vessels
FORMS: CG-5397
OMB NO: 1625-0023 EXPIRATION DATE: 11/30/2003
RESPS:50 HOURS:30,618 COSTS(000):$0
Barge Fleeting Facility Records
FORMS: NONE
OMB NO: 1625-0024 EXPIRATION DATE: 12/31/2004
RESPS:2,622,656 HOURS:101,732 COSTS(000):$0
Safety Approval of Cargo Containers
FORMS: NONE
OMB NO: 1625-0025 EXPIRATION DATE: 07/31/2004
RESPS:1,538 HOURS:830 COSTS(000):$0
Carriage of Bulk Solids Requiring Special Handling -- 46 CFR
Part 148
FORMS: NONE
OMB NO: 1625-0026 EXPIRATION DATE: 09/30/2003
RESPS:61 HOURS:65 COSTS(000):$0
Plan Approval and Records for Foreign Vessels Carrying Oil in
Bulk
FORMS: NONE
OMB NO: 1625-0027 EXPIRATION DATE: 06/30/2004
RESPS:180,030 HOURS:50,452 COSTS(000):$0
Vessel Documentation
FORMS: CG1258 CG1261 CG1270 CG1280 CG1280A CG1280B CG1340 CG1356 CG4593
CG5542
OMB NO: 1625-0028 EXPIRATION DATE: 11/30/2005
RESPS:375 HOURS:16,988 COSTS(000):$0
Course Approvals for Merchant Marine Training Schools
FORMS: NONE
OMB NO: 1625-0029 EXPIRATION DATE: 03/31/2005
RESPS:326 HOURS:5,131 COSTS(000):$0
Self-propelled Liquefied Gas Vessels
FORMS: CG-4355
OMB NO: 1625-0030 EXPIRATION DATE: 04/30/2004
RESPS:211 HOURS:106 COSTS(000):$0
Oil and Hazardous Materials Transfer Procedures
FORMS: NONE
OMB NO: 1625-0031 EXPIRATION DATE: 03/31/2005
RESPS:1,153 HOURS:1,153 COSTS(000):$0
Electrical Engineering Regulations--Title 46 CFR Subchapter J
FORMS: NONE
OMB NO: 1625-0032 EXPIRATION DATE: 06/30/2005
RESPS:3,405 HOURS:1,578 COSTS(000):$0
Vessel Inspection Related Forms and Posting Requirements Under
Title 46 U.S. Code
FORMS: CG-841 CG-854 CG-948 CG-949 CG-950 CG-950A CG-2832 CG-4504
OMB NO: 1625-0033 EXPIRATION DATE: 09/30/2003
RESPS:1,596 HOURS:798 COSTS(000):$0
Display of Fire Control Plans for Vessels
FORMS: NONE
OMB NO: 1625-0034 EXPIRATION DATE: 11/30/2005
RESPS:2 HOURS:6 COSTS(000):$0
Ships' Stores Certification for Hazardous Materials Aboard Ships
FORMS: NONE
OMB NO: 1625-0035 EXPIRATION DATE: 12/31/2005
RESPS:2,178 HOURS:16,880 COSTS(000):$0
Title 46 CFR Subchapter Q: Lifesaving, Electrical, and
Engineering Equipment, Construction and Materials (Consolidates
COIs 2115-0121, 0141, 0525, 0576, 0577 & 0619)
FORMS: 10030
OMB NO: 1625-0036 EXPIRATION DATE: 12/31/2004
RESPS:2,023 HOURS:443 COSTS(000):$0
Plan Approval and Records for Vessels Carrying Oil in Bulk
FORMS: NONE
OMB NO: 1625-0037 EXPIRATION DATE: 07/31/2005
RESPS:36,656 HOURS:17,555 COSTS(000):$0
Tank Vessel Examination Letters, Certificates of Compliance,
Boiler/Pressure Vessel Repairs, Cargo Gear Records, and Shipping
Papers
FORMS: CG-840S-1 CG-840S-2 CG-3583
OMB NO: 1625-0038 EXPIRATION DATE: 08/31/2003
RESPS:11,963 HOURS:6,472 COSTS(000):$0
Plan Approval & Records for Tank, Passenger, Cargo & Miscellan-
eous Vessels, Mobile Off-shore Drilling Units, Nautical Schools,
Oceanographic Vessels & Electrictal Engineering
FORMS: NONE
OMB NO: 1625-0039 EXPIRATION DATE: 08/31/2003
RESPS:92,283 HOURS:28,332 COSTS(000):$0
Declaration of Inspection Before Transfer of Liquid Cargo in Bulk
FORMS: NONE
OMB NO: 1625-0040 EXPIRATION DATE: 01/31/2005
RESPS:48,029 HOURS:21,358 COSTS(000):$0
Submission of continuous discharge book, revised merchant
mariner application, physical report new sea service, chemical
testing and entry level physical forms.
FORMS: CG-719A CG-719B CG-719K CG-719S CG-719P CG-719K/E
OMB NO: 1625-0041 EXPIRATION DATE: 02/29/2004
RESPS:1,889 HOURS:6,858 COSTS(000):$0
International Oil Pollution Prevention Certificate
FORMS: CG-5352 CG-5352A CG-5352B
OMB NO: 1625-0042 EXPIRATION DATE: 07/31/2005
RESPS:1,300 HOURS:228 COSTS(000):$0
Requirements for Lightering of Oil and Hazardous Material Cargoes
FORMS: NONE
OMB NO: 1625-0043 EXPIRATION DATE: 09/30/2005
RESPS:1,339 HOURS:2,929 COSTS(000):$0
Ports and Waterways Safety -- Title 33 CFR Subchapter P
FORMS: NONE
OMB NO: 1625-0044 EXPIRATION DATE: 09/30/2003
RESPS:263 HOURS:526 COSTS(000):$0
Station Bill for Manned Outer Continental Shelf Facilities
FORMS: NONE
OMB NO: 1625-0045 EXPIRATION DATE: 12/31/2004
RESPS:4,182 HOURS:1,215 COSTS(000):$0
Advance Notice and Adequacy Certification for Reception
Facilities
FORMS: CG-5401 CG-5401A CG-5401B CG-5401C
OMB NO: 1625-0046 EXPIRATION DATE: 06/30/2003
RESPS:1 HOURS:2,162 COSTS(000):$0
Financial Responsibility for Water Pollution (Vessels)
FORMS: CG-5585 CG-5586 CG-5586-1 CG-5586-2 CG-5586-3 CG-5586-4
CG-5586-5
OMB NO: 1625-0047 EXPIRATION DATE: 08/31/2003
RESPS:765 HOURS:57,375 COSTS(000):$0
Vital System Automation -- 46 CFR Parts 52, 56, 58, 61, 62, 110,
111, and 113
FORMS: NONE
OMB NO: 1625-0048 EXPIRATION DATE: 04/30/2003
RESPS:546 HOURS:137 COSTS(000):$0
Vessel Reporting Requirement
FORMS: NONE
OMB NO: 1625-0049 EXPIRATION DATE: 01/31/2004
RESPS:463 HOURS:3,272 COSTS(000):$0
Liquefied Natural Gas and Liquefied Hazardous Gas Waterfront
Facilities
FORMS: NONE
OMB NO: 1625-0050 EXPIRATION DATE: 12/31/2004
RESPS:5 HOURS:50 COSTS(000):$0
Approval of Equivalent Equipment or Procedures Other than those
Specified in Title 33 CFR Subchapter N
FORMS: NONE
OMB NO: 1625-0051 EXPIRATION DATE: 11/30/2005
RESPS:30 HOURS:10 COSTS(000):$0
a) Reports of MARPOL 73/78 oil, noxious liquid substance (NLS)
and garbage discharge; b) Application for equivalents,
exemptions and alternatives; c) Pollution sightings
FORMS: NONE
OMB NO: 1625-0052 EXPIRATION DATE: 09/30/2003
RESPS:13 HOURS:84 COSTS(000):$0
Nondestructive Testing Proposal and Results for Pressure Vessel
Cargo Tanks on Unmanned Barges
FORMS: NONE
OMB NO: 1625-0053 EXPIRATION DATE: 01/31/2004
RESPS:15 HOURS:46 COSTS(000):$0
Hopper Dredge Working Freeboard - - Load Line and Stability
FORMS: NONE
OMB NO: 1625-0054 EXPIRATION DATE: 03/31/2005
RESPS:3,489 HOURS:3,884 COSTS(000):$0
Self Inspection of Fixed Outer Continental Shelf (OCS) Facilities
FORMS: CG-5432
OMB NO: 1625-0055 EXPIRATION DATE: 01/31/2004
RESPS:13 HOURS:143 COSTS(000):$0
Alternative Provisions for Reinspection of Offshore Supply
Vessels in Foreign Ports
FORMS: NONE
OMB NO: 1625-0056 EXPIRATION DATE: 08/31/2003
RESPS:261 HOURS:382,798 COSTS(000):$0
Labeling Requirements in 33 CFR Parts 181 and 183
FORMS: NONE
OMB NO: 1625-0057 EXPIRATION DATE: 09/30/2003
RESPS:6,753 HOURS:436,173 COSTS(000):$0
Small Passenger Vessels -- Title 46 CFR Subchapters K and T
FORMS: CG-841 CG-854 CG-948 CG-949 CG-3752 CG-5256
OMB NO: 1625-0058 EXPIRATION DATE: 12/31/2004
RESPS:350 HOURS:391 COSTS(000):$0
Application for Permit to Transport Municipal and Commercial
Waste
FORMS: NONE
OMB NO: 1625-0059 EXPIRATION DATE: 06/30/2004
RESPS:268 HOURS:884 COSTS(000):$0
Outer Continental Shelf Activities -- Emergency Evacuation Plans
for Manned OCS Facilities; Design & Plan Approvals; In-service
Inspection & Letter of Compliance
FORMS: NONE
OMB NO: 1625-0060 EXPIRATION DATE: 07/31/2005
RESPS:122 HOURS:1,073 COSTS(000):$0
Vapor Control Systems for Facilities and Tank Vessels
FORMS: NONE
OMB NO: 1625-0061 EXPIRATION DATE: 12/31/2004
RESPS:6,925 HOURS:8,205 COSTS(000):$0
Commercial Fishing Industry Vessel Safety Regulations
FORMS: NONE
OMB NO: 1625-0062 EXPIRATION DATE: 10/31/2004
RESPS:1 HOURS:18 COSTS(000):$0
Approval of Alterations to Marine Portable Tanks; Approval of
Non-Specification Portable Tanks
FORMS: NONE
OMB NO: 1625-0063 EXPIRATION DATE: 06/30/2003
RESPS:200 HOURS:59,755 COSTS(000):$0
Marine Occupational Health and Safety Standards for Benzene--46
CFR 197 Subpart C
FORMS: NONE
OMB NO: 1625-0064 EXPIRATION DATE: 01/31/2004
RESPS:3,250 HOURS:10,003 COSTS(000):$0
Plan Approval and Records for Subdivision and Stability
Regulations--Title 46 CFR Subchapter S
FORMS: NONE
OMB NO: 1625-0065 EXPIRATION DATE: 09/30/2003
RESPS:580 HOURS:5,931 COSTS(000):$0
Offshore Supply Vessels -- 46 CFR Subchapter L
FORMS: NONE
OMB NO: 1625-0066 EXPIRATION DATE: 08/31/2003
RESPS:5,207 HOURS:188,733 COSTS(000):$0
Vessel Response Plans, Facility Response Plans, Shipboard Oil
Pollution Emergency Plans, and Additional Response Equipment
Requirements for Prince William Sound
FORMS: NONE
OMB NO: 1625-0067 EXPIRATION DATE: 04/30/2005
RESPS:831 HOURS:13,722 COSTS(000):$0
Claims under the Oil Pollution Act of 1990
FORMS: NONE
OMB NO: 1625-0068 EXPIRATION DATE: 04/30/2005
RESPS:1 HOURS:3 COSTS(000):$0
State access to the oil spill liability trust fund for removal
costs under the Oil Pollution Act of 1990
FORMS: NONE
OMB NO: 1625-0069 EXPIRATION DATE: 11/30/2005
RESPS:50,000 HOURS:33,500 COSTS(000):$0
Ballast Water Management for Vessels with Ballast Tanks Entering
U.S. Waters
FORMS: CG-5662
OMB NO: 1625-0070 EXPIRATION DATE: 06/30/2003
RESPS:123,582 HOURS:5,697 COSTS(000):$308
Vessel Identification System
FORMS: NONE
OMB NO: 1625-0071 EXPIRATION DATE: 07/31/2003
RESPS:1 HOURS:80 COSTS(000):$0
Boat Owner's Report - Possible Safety Defect
FORMS: CG-5578
OMB NO: 1625-0072 EXPIRATION DATE: 04/30/2004
RESPS:5,707 HOURS:59,653 COSTS(000):$0
Waste Management Plans, Refuse Discharge Logs, and Letters of
Instruction for Certain Persons-in-Charge (PIC)
FORMS: NONE
OMB NO: 1625-0073 EXPIRATION DATE: 06/30/2003
RESPS:3 HOURS:120 COSTS(000):$0
Alteration of Unreasonably Obstructive Bridges under the
Truman-Hobbs (T-H) Act
FORMS: NONE
OMB NO: 1625-0074 EXPIRATION DATE: 02/29/2004
RESPS:18,823 HOURS:4,648 COSTS(000):$0
Direct User Fees for Inspection or Examination of U.S. and
Foreign Commercial Vessels
FORMS: CG-5565 CG-5565A
OMB NO: 1625-0075 EXPIRATION DATE: 06/30/2004
RESPS:1,600 HOURS:320 COSTS(000):$0
Boating Statistics Questionnaire
FORMS: NONE
OMB NO: 1625-0076 EXPIRATION DATE: 09/30/2004
RESPS:50 HOURS:1,406 COSTS(000):$0
Inflatable Personal Flotation Devices for Recreational Vessels
FORMS: NONE
OMB NO: 1625-0077 EXPIRATION DATE: 06/30/2003
RESPS:95 HOURS:1,811 COSTS(000):$0
Security of Passenger Vessels and Passenger Terminals
FORMS: NONE
OMB NO: 1625-0078 EXPIRATION DATE: 05/31/2004
RESPS:226 HOURS:15,338 COSTS(000):$0
Licensing and Manning Requirements for Officers on Towing Vessels
FORMS: NONE
OMB NO: 1625-0079 EXPIRATION DATE: 02/28/2006
RESPS:14,995 HOURS:18,693 COSTS(000):$0
Standards of Training, Certification and Watchkeeping for
Seafarers (STCW), 1995 and 1997 Amendments to the International
Convention
FORMS: NONE
OMB NO: 1625-0080 EXPIRATION DATE: 09/30/2003
RESPS:13,485 HOURS:4,712 COSTS(000):$0
Customer Satisfaction Surveys
FORMS: NONE
OMB NO: 1625-0081 EXPIRATION DATE: 07/31/2005
RESPS:75 HOURS:150 COSTS(000):$0
Alternate Compliance Program
FORMS: CG-3752
OMB NO: 1625-0082 EXPIRATION DATE: 03/31/2004
RESPS:26,830 HOURS:281,998 COSTS(000):$0
Navigation Safety Equipment and Emergency Instructions for
Certain Towing Vessels
FORMS: NONE
OMB NO: 1625-0083 EXPIRATION DATE: 07/31/2005
RESPS:47,363 HOURS:18,006 COSTS(000):$0
Operational Measures for Existing Tank Vessels Without Double
Hulls
FORMS: NONE
OMB NO: 1625-0084 EXPIRATION DATE: 07/31/2003
RESPS:2,988 HOURS:3,650 COSTS(000):$0
International Safety Management Code Audit Reports
FORMS: NONE
OMB NO: 1625-0085 EXPIRATION DATE: 01/31/2005
RESPS:1,907 HOURS:32,244 COSTS(000):$0
Streamlined Inspection Program
FORMS: NONE
OMB NO: 1625-0086 EXPIRATION DATE: 10/31/2003
RESPS:60 HOURS:18 COSTS(000):$0
Great Lakes Pilotage Rate Methodology
FORMS: NONE
OMB NO: 1625-0087 EXPIRATION DATE: 03/31/2005
RESPS:300 HOURS:125 COSTS(000):$0
U.S. Coast Guard International Ice Patrol (IIP) Customer Survey
FORMS: NONE
OMB NO: 1625-0088 EXPIRATION DATE: 10/31/2004
RESPS:877 HOURS:439 COSTS(000):$0
Voyage Planning for Tank Barge Transits in the Northeast United
States
FORMS: NONE
OMB NO: 1625-0089 EXPIRATION DATE: 08/31/2005
RESPS:87,500 HOURS:11,458 COSTS(000):$0
The National Recreational Boating Survey
FORMS: NONE
OMB NO: 1625-0090 EXPIRATION DATE: 09/30/2003
RESPS:2,784 HOURS:1,624 COSTS(000):$0
Understanding How Mariners Use Aids to Navigation - A Tool for
the Coast Guard's Office of Aids to Navigation
FORMS: NONE
OMB NO: 1625-0091 EXPIRATION DATE: 09/30/2003
RESPS:27 HOURS:54 COSTS(000):$0
Certification of Navigation Lights for Recreational and
Uninspected Vessels
FORMS: NONE
OMB NO: 1625-0092 EXPIRATION DATE: 09/30/2004
RESPS:23 HOURS:230 COSTS(000):$0
Sewage and Graywater Discharge Records for Certain Cruise
Vessels Operating on Alaskan Waters
FORMS: NONE
OMB NO: 1625-0093 EXPIRATION DATE: 03/31/2006
RESPS:1,395 HOURS:27,819 COSTS(000):$0
Facilities Transferring Oil or Hazardous Materials in Bulk --
Letter of Intent and Operations Manual
FORMS: NONE
OMB NO: 1625-0094 EXPIRATION DATE: 03/31/2006
RESPS:158 HOURS:738 COSTS(000):$0
Ships Carrying Bulk Hazardous Liquid
FORMS: CG-4602B CG-5148 CG-5461 CG-5148A CG-5148B
OMB NO: 1625-0095 EXPIRATION DATE: 03/31/2006
RESPS:168 HOURS:1,440 COSTS(000):$0
Oil and Hazardous Material Pollution Prevention and Safety
Records, Equivalents/Alternatives and Exemptions
FORMS: NONE
OMB NO: 1625-0096 EXPIRATION DATE: 03/31/2006
RESPS:104,000 HOURS:8,667 COSTS(000):$0
Report of Oil or Hazardous Substance Discharge
FORMS: NONE
OMB NO: 1625-0097 EXPIRATION DATE: 03/31/2006
RESPS:3,090 HOURS:3,090 COSTS(000):$0
Plan Approval and Records for Marine Engineering Systems - 46
CFR Subchapter F
FORMS: NONE
OMB NO: 1625-0098 EXPIRATION DATE: 03/31/2006
RESPS:6,633 HOURS:442 COSTS(000):$0
Records Relating to Citizenship of Personnel on Units Engaged in
Outer Continental Shelf (OCS) Activities
FORMS: NONE
OMB NO: 1625-0099 EXPIRATION DATE: 03/31/2006
RESPS:5,360 HOURS:2,680 COSTS(000):$0
Requirements for the Use of Liquefied Petroleum Gas and
Compressed Natural Gas as Cooking Fuel on Passenger Vessels
FORMS: NONE
OMB NO: 1625-0100 EXPIRATION DATE: 03/31/2006
RESPS:68,139 HOURS:174,179 COSTS(000):$0
Advance Notice of Vessel Arrival and Departure
FORMS: I-418 1302
OMB NO: 1625-0101 EXPIRATION DATE: 03/31/2006
RESPS:236 HOURS:13,688 COSTS(000):$0
Periodic Gauging and Engineering Analyses for Certain Tank
Vessels Over 30 Years Old
FORMS: NONE
OMB NO: 1625-0102 EXPIRATION DATE: 03/31/2006
RESPS:85 HOURS:1,224 COSTS(000):$0
National Response Resource Inventory
FORMS: NONE
OMB NO: 1625-0103 EXPIRATION DATE: 03/31/2006
RESPS:1,098 HOURS:88 COSTS(000):$0
Mandatory Ship Reporting System for the Northeast and Southest
Coasts of the United States
FORMS: NONE
OMB NO: 1625-0104 EXPIRATION DATE: 03/31/2006
RESPS:911 HOURS:10,903 COSTS(000):$0
Barges Carrying Bulk Hazardous Materials
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
104 4,022,262 2,385,736 $308
Bureau of Customs and Border Protection
OMB NO: 1651-0001 EXPIRATION DATE: 10/31/2005
RESPS:12,828,300 HOURS:1,852,825 COSTS(000):$0
Transportation Manifest (Cargo Declaration)
FORMS: CF-1302 CF-1302A
OMB NO: 1651-0002 EXPIRATION DATE: 05/31/2003
RESPS:1,500,000 HOURS:49,950 COSTS(000):$0
General Declaration (Outward/Inward)
FORMS: FORM-7507
OMB NO: 1651-0003 EXPIRATION DATE: 09/30/2004
RESPS:560,000 HOURS:56,000 COSTS(000):$0
Transportation Entry and Manifest of Goods Subject to Customs
Inspection and Permit
FORMS: CF-7512
OMB NO: 1651-0004 EXPIRATION DATE: 09/30/2004
RESPS:15,000 HOURS:2,000 COSTS(000):$0
Application for Exportation of Articles under Special Bond
FORMS: FORM-3495
OMB NO: 1651-0005 EXPIRATION DATE: 11/30/2003
RESPS:399,000 HOURS:39,900 COSTS(000):$0
Application-Permit-Special License Unlading/Lading, Overtime
Services
FORMS: FORM-3171
OMB NO: 1651-0006 EXPIRATION DATE: 06/30/2003
RESPS:137,400 HOURS:13,740 COSTS(000):$0
Application and Approval to Manipulate, Examine, Sample, or
Transfer Goods
FORMS: FORM-3499
OMB NO: 1651-0007 EXPIRATION DATE: 12/31/2003
RESPS:12,000 HOURS:1,600 COSTS(000):$0
Application for Allowance in Duties
FORMS: FORM-4315
OMB NO: 1651-0008 EXPIRATION DATE: 06/30/2005
RESPS:45,000 HOURS:9,750 COSTS(000):$0
Application for Identification Card
FORMS: 3078
OMB NO: 1651-0009 EXPIRATION DATE: 08/31/2005
RESPS:60,000,000 HOURS:3,960,000 COSTS(000):$0
U.S. Customs Declaration
FORMS: 6059-B
OMB NO: 1651-0010 EXPIRATION DATE: 08/31/2003
RESPS:200,000 HOURS:10,000 COSTS(000):$0
Certificate of Registration
FORMS: 4455 4457
OMB NO: 1651-0011 EXPIRATION DATE: 08/31/2003
RESPS:420,000 HOURS:51,000 COSTS(000):$0
Declaration for Free Entry of Returned American Products
FORMS: FORMS-3311
OMB NO: 1651-0012 EXPIRATION DATE: 05/31/2003
RESPS:102,000 HOURS:8,497 COSTS(000):$0
Lien Notice
FORMS: FORM-3485
OMB NO: 1651-0013 EXPIRATION DATE: 10/31/2005
RESPS:99,000 HOURS:8,247 COSTS(000):$0
Entry and Manifest of Merchandise Free of Duty, Carrier's
Certificate and Release
FORMS: 7523
OMB NO: 1651-0014 EXPIRATION DATE: 10/31/2003
RESPS:150,000 HOURS:25,000 COSTS(000):$0
Declaration for Free Entry of Unaccompanied Articles
FORMS: FORM-3299
OMB NO: 1651-0015 EXPIRATION DATE: 06/30/2003
RESPS:16,800 HOURS:348 COSTS(000):$0
Application for Extension of Bond for Temporary Importation
FORMS: FORM-3499
OMB NO: 1651-0016 EXPIRATION DATE: 09/30/2005
RESPS:310 HOURS:113 COSTS(000):$0
Certificate of Origin
FORMS: 3229
OMB NO: 1651-0017 EXPIRATION DATE: 07/31/2003
RESPS:45,330 HOURS:67,995 COSTS(000):$0
Protest
FORMS: FORM-19
OMB NO: 1651-0018 EXPIRATION DATE: 08/31/2005
RESPS:104,300 HOURS:26,000 COSTS(000):$0
Ship's Stores Declaration
FORMS: 1303
OMB NO: 1651-0019 EXPIRATION DATE: 10/31/2005
RESPS:264,000 HOURS:21,991 COSTS(000):$0
Vessel Entrance or Clearance Statement Form
FORMS: 1300
OMB NO: 1651-0020 EXPIRATION DATE: 10/31/2005
RESPS:206,100 HOURS:17,168 COSTS(000):$0
Crew Effects Declaration
FORMS: 1304
OMB NO: 1651-0021 EXPIRATION DATE: 08/31/2003
RESPS:5,968,351 HOURS:298,418 COSTS(000):$0
Crew Members Declaration
FORMS: 5129
OMB NO: 1651-0022 EXPIRATION DATE: 10/31/2005
RESPS:22,001,956 HOURS:6,627,678 COSTS(000):$0
Entry Summary and Continuation Sheet
FORMS: 7501 7501A
OMB NO: 1651-0023 EXPIRATION DATE: 06/30/2005
RESPS:60,000 HOURS:60,000 COSTS(000):$0
Request for Information
FORMS: FORM-28
OMB NO: 1651-0024 EXPIRATION DATE: 10/31/2005
RESPS:18,654,229 HOURS:2,775,043 COSTS(000):$0
Immediate Delivery Application
FORMS: 3461 3461-ALTERNATE
OMB NO: 1651-0025 EXPIRATION DATE: 08/31/2005
RESPS:2,800 HOURS:233 COSTS(000):$0
Report of Diversion
FORMS: 26
OMB NO: 1651-0026 EXPIRATION DATE: 08/31/2005
RESPS:3,800 HOURS:3,800 COSTS(000):$0
Customshouse Broker's License/Permit
FORMS: 3124 3124E
OMB NO: 1651-0027 EXPIRATION DATE: 06/30/2005
RESPS:2,000 HOURS:1,500 COSTS(000):$0
Record of Vessel Foreign Repair or Equipment
FORMS: FORM-226
OMB NO: 1651-0028 EXPIRATION DATE: 01/31/2005
RESPS:1,000 HOURS:50,000 COSTS(000):$0
Cost Submission
FORMS: 247
OMB NO: 1651-0029 EXPIRATION DATE: 11/30/2003
RESPS:325,000 HOURS:79,500 COSTS(000):$0
Application for Foreign Trade Zone Admission and Status
Designation
FORMS: FORMS-214 214A 214B 214C 216
OMB NO: 1651-0030 EXPIRATION DATE: 06/30/2005
RESPS:15,000 HOURS:1,250 COSTS(000):$0
Declaration of Unaccompanied Articles
FORMS: FORM-255
OMB NO: 1651-0031 EXPIRATION DATE: 08/31/2003
RESPS:259,350 HOURS:302,402 COSTS(000):$0
Foreign Assemblers Declaration (with Endorsement by Importer)
FORMS: NONE
OMB NO: 1651-0032 EXPIRATION DATE: 05/31/2003
RESPS:12,000 HOURS:13,000 COSTS(000):$0
Importers of Merchandise Subject to Actual Use Provisions
FORMS: NONE
OMB NO: 1651-0033 EXPIRATION DATE: 05/31/2003
RESPS:1,800 HOURS:36,000 COSTS(000):$0
Bonded Warehouse Proprietor's Submission
FORMS: FORM-300
OMB NO: 1651-0034 EXPIRATION DATE: 06/30/2005
RESPS:7,100 HOURS:5,450 COSTS(000):$0
Customs Regulations Pertaining to Customhouse Brokers
FORMS: NONE
OMB NO: 1651-0035 EXPIRATION DATE: 11/30/2003
RESPS:20 HOURS:90 COSTS(000):$0
Holders or Containers Which Enter the United States Duty Free
FORMS: NONE
OMB NO: 1651-0036 EXPIRATION DATE: 01/31/2005
RESPS:165 HOURS:27 COSTS(000):$0
Declaration of Ultimate Consignee That Articles Were Exported
for Temporary Scientific or Educational Purposes
FORMS: NONE
OMB NO: 1651-0037 EXPIRATION DATE: 06/30/2005
RESPS:1,600 HOURS:530 COSTS(000):$0
Entry of Articles for Exhibition
FORMS: NONE
OMB NO: 1651-0038 EXPIRATION DATE: 05/31/2003
RESPS:10,500 HOURS:3,500 COSTS(000):$0
Proof of Use rates of Duty Dependent on Actual Use
FORMS: NONE
OMB NO: 1651-0039 EXPIRATION DATE: 01/31/2005
RESPS:7,500 HOURS:1,880 COSTS(000):$0
Declaration by the Person Who Performed the Processing of Goods
Abroad
FORMS: NONE
OMB NO: 1651-0040 EXPIRATION DATE: 08/31/2005
RESPS:205 HOURS:615 COSTS(000):$0
Establishment of a Container Station
FORMS: NONE
OMB NO: 1651-0041 EXPIRATION DATE: 08/31/2005
RESPS:54 HOURS:162 COSTS(000):$0
Establishment of a Bonded Warehouse
FORMS: NONE
OMB NO: 1651-0042 EXPIRATION DATE: 02/28/2006
RESPS:1,078 HOURS:539 COSTS(000):$0
Disclosure of Information on Vessel Manifest
FORMS: NONE
OMB NO: 1651-0043 EXPIRATION DATE: 08/31/2005
RESPS:2 HOURS:16 COSTS(000):$0
Application for Bonding of Smelting and Refining
FORMS: NONE
OMB NO: 1651-0044 EXPIRATION DATE: 07/31/2003
RESPS:1 HOURS:1 COSTS(000):$0
Free Admittance Under Conditions of Emergency
FORMS: NONE
OMB NO: 1651-0045 EXPIRATION DATE: 08/31/2005
RESPS:9,000 HOURS:4,500 COSTS(000):$0
Application to Receive Free Materials in a Bonded Warehouse
FORMS: NONE
OMB NO: 1651-0046 EXPIRATION DATE: 08/31/2005
RESPS:198 HOURS:232 COSTS(000):$0
Bonded Warehouses-Alterations, Suspensions, Relocations &
Discontinuances
FORMS: NONE
OMB NO: 1651-0047 EXPIRATION DATE: 05/31/2003
RESPS:15 HOURS:156 COSTS(000):$0
Required Records for Smelting and Refining Warehouses
FORMS: NONE
OMB NO: 1651-0048 EXPIRATION DATE: 05/31/2003
RESPS:20,472 HOURS:10,236 COSTS(000):$0
Declaration of Persons Who Perform Repairs or Alterations
FORMS: NONE
OMB NO: 1651-0049 EXPIRATION DATE: 08/31/2005
RESPS:1,400 HOURS:466 COSTS(000):$0
Permit to Transfer Containers to a Container Station
FORMS: NONE
OMB NO: 1651-0050 EXPIRATION DATE: 01/31/2005
RESPS:590,250 HOURS:147,596 COSTS(000):$0
Importation Bond Structure
FORMS: 301 5297
OMB NO: 1651-0051 EXPIRATION DATE: 10/31/2005
RESPS:260 HOURS:195 COSTS(000):$0
Foreign Trade Zones Annual Reconciliation and Record Keeping
Requirement
FORMS: NONE
OMB NO: 1651-0052 EXPIRATION DATE: 05/31/2005
RESPS:120,100 HOURS:16,100 COSTS(000):$0
User Fees
FORMS: 339
OMB NO: 1651-0053 EXPIRATION DATE: 07/31/2004
RESPS:1 HOURS:250 COSTS(000):$0
Approval of Commercial Gaugers & Accreditation of Commercial
Laboratories
FORMS: NONE
OMB NO: 1651-0054 EXPIRATION DATE: 06/30/2003
RESPS:600,000 HOURS:100,000 COSTS(000):$0
Exportation of Self-Propelled Vehicles
FORMS: NONE
OMB NO: 1651-0055 EXPIRATION DATE: 07/31/2003
RESPS:2,500,000 HOURS:1,250,000 COSTS(000):$0
Harbor Maintenance Fee
FORMS: 349 350
OMB NO: 1651-0056 EXPIRATION DATE: 09/30/2004
RESPS:300 HOURS:25 COSTS(000):$0
Importation of Ethyl Alcohol for Non-Beverage Purposes
FORMS: NONE
OMB NO: 1651-0057 EXPIRATION DATE: 05/31/2003
RESPS:10,000 HOURS:41 COSTS(000):$0
Country of Origin Marking Requirements for Containers or Holders
FORMS: NONE
OMB NO: 1651-0058 EXPIRATION DATE: 11/30/2005
RESPS:150,000 HOURS:2,490 COSTS(000):$0
Documents Required Aboard Private Aircraft
FORMS: NONE
OMB NO: 1651-0059 EXPIRATION DATE: 10/31/2005
RESPS:1,700 HOURS:425 COSTS(000):$0
Automotive Products Act of 1965
FORMS: NONE
OMB NO: 1651-0060 EXPIRATION DATE: 09/30/2005
RESPS:25,700 HOURS:6,425 COSTS(000):$0
Line Release/Border Release Advanced Screening and Selectivity
(BRASS)
FORMS: NONE
OMB NO: 1651-0061 EXPIRATION DATE: 10/31/2003
RESPS:50 HOURS:100 COSTS(000):$0
Centralized Examination Station
FORMS: NONE
OMB NO: 1651-0062 EXPIRATION DATE: 08/31/2005
RESPS:31,200 HOURS:1,030 COSTS(000):$0
Air Waybill
FORMS: NONE
OMB NO: 1651-0063 EXPIRATION DATE: 06/30/2003
RESPS:936 HOURS:13,176 COSTS(000):$0
Petroleum Refineries in Foreign Trade Subzones
FORMS: NONE
OMB NO: 1651-0064 EXPIRATION DATE: 07/31/2003
RESPS:1,000 HOURS:100 COSTS(000):$0
Importer Input Record
FORMS: FORMS-5106
OMB NO: 1651-0065 EXPIRATION DATE: 01/31/2005
RESPS:34,500 HOURS:7,505 COSTS(000):$0
U.S./Israel Free Trade Agreement
FORMS: NONE
OMB NO: 1651-0066 EXPIRATION DATE: 06/30/2005
RESPS:325 HOURS:200 COSTS(000):$0
Report of Loss, Detention, or Accident by Bonded Carrier,
Cartman, Lighterman, Foreign Trade Zone Operator, or Centralized
Examination Station Operator.
FORMS: NONE
OMB NO: 1651-0067 EXPIRATION DATE: 08/31/2005
RESPS:58,300 HOURS:14,575 COSTS(000):$0
Documentation Requirements for Articles Entered Under Various
Special Treatment Provisions
FORMS: NONE
OMB NO: 1651-0068 EXPIRATION DATE: 08/31/2003
RESPS:310 HOURS:31 COSTS(000):$0
Importers Declaration/Shippers Declaration
FORMS: NONE
OMB NO: 1651-0069 EXPIRATION DATE: 08/31/2004
RESPS:6,500 HOURS:2,750 COSTS(000):$0
Voluntary Customer Information Surveys in Support of Executive
Order 12862
FORMS: NONE
OMB NO: 1651-0070 EXPIRATION DATE: 01/31/2005
RESPS:2,000 HOURS:667 COSTS(000):$0
Articles Assembled Abroad with Textile Components Cut to Shape
in the U.S.
FORMS: NONE
OMB NO: 1651-0071 EXPIRATION DATE: 06/30/2005
RESPS:1,400 HOURS:280 COSTS(000):$0
NAFTA Duty Deferral
FORMS: NONE
OMB NO: 1651-0072 EXPIRATION DATE: 06/30/2005
RESPS:360 HOURS:360 COSTS(000):$0
Certificate of Compliance for Turbine Fuel Withdrawals
FORMS: NONE
OMB NO: 1651-0073 EXPIRATION DATE: 08/31/2005
RESPS:1,350 HOURS:2,700 COSTS(000):$0
Notice of Detention
FORMS: NONE
OMB NO: 1651-0074 EXPIRATION DATE: 10/31/2005
RESPS:3,500 HOURS:3,500 COSTS(000):$0
Prior Disclosure
FORMS: NONE
OMB NO: 1651-0075 EXPIRATION DATE: 05/31/2004
RESPS:163,000 HOURS:90,000 COSTS(000):$0
Drawback Process Regulations and Entry Collection Documents.
FORMS: 7551 7552 7553
OMB NO: 1651-0076 EXPIRATION DATE: 05/31/2003
RESPS:9,114 HOURS:7,977,600 COSTS(000):$9,500
Customs Modernization Act Recordkeeping Requirements
FORMS: NONE
OMB NO: 1651-0077 EXPIRATION DATE: 04/30/2004
RESPS:5,250 HOURS:5,250 COSTS(000):$0
Land Border Carrier Initiative Program
FORMS: NONE
OMB NO: 1651-0078 EXPIRATION DATE: 08/31/2005
RESPS:3,000 HOURS:232 COSTS(000):$0
Automated Clearinghouse Credit
FORMS: NONE
OMB NO: 1651-0079 EXPIRATION DATE: 06/30/2005
RESPS:50,700 HOURS:12,675 COSTS(000):$0
Lay Order Period-General Order Merchandise
FORMS: NONE
OMB NO: 1651-0080 EXPIRATION DATE: 07/31/2003
RESPS:28 HOURS:28 COSTS(000):$0
Deferral of Duty on Large Yachts Imported for Sale
FORMS: NONE
OMB NO: 1651-0081 EXPIRATION DATE: 09/30/2003
RESPS:20,000 HOURS:6,600 COSTS(000):$0
Delivery Ticket
FORMS: FORM-6043
OMB NO: 1651-0082 EXPIRATION DATE: 08/31/2004
RESPS:31,150 HOURS:10,400 COSTS(000):$0
African Growth and Opportunity Act Certificate of Origin
FORMS: NONE
OMB NO: 1651-0083 EXPIRATION DATE: 08/31/2004
RESPS:57,400 HOURS:18,720 COSTS(000):$0
United States-Caribbean Basin Trade Partnership Act
FORMS: FORM-450
OMB NO: 1651-0084 EXPIRATION DATE: 10/31/2003
RESPS:60 HOURS:8,600 COSTS(000):$0
Refund of Duties Paid on Imports of Certain Wool Products
FORMS: N/A
OMB NO: 1651-0085 EXPIRATION DATE: 12/31/2003
RESPS:12,200 HOURS:128,000 COSTS(000):$0
Administrative Rulings
FORMS: NONE
OMB NO: 1651-0086 EXPIRATION DATE: 07/31/2004
RESPS:1 HOURS:1 COSTS(000):$0
Distribution of Continued Dumping and Subsidy Offset to Affected
Domestic Producers
FORMS: NONE
OMB NO: 1651-0087 EXPIRATION DATE: 01/31/2005
RESPS:5,500 HOURS:218 COSTS(000):$0
Application for Exemption from Special Landing Requirements
Overflight/GATE
FORMS: FORM-442
OMB NO: 1651-0088 EXPIRATION DATE: 08/31/2005
RESPS:850,000 HOURS:2,380 COSTS(000):$0
Passenger and Crew Manifest for Passenger Flights
FORMS: NONE
OMB NO: 1651-0089 EXPIRATION DATE: 06/30/2005
RESPS:752,000 HOURS:12,833 COSTS(000):$0
Advance Notice Requirements for Aircraft Landings and Arrivals
FORMS: NONE
OMB NO: 1651-0090 EXPIRATION DATE: 03/31/2005
RESPS:46,500,000 HOURS:130,200 COSTS(000):$0
Commercial Invoice
FORMS: NONE
OMB NO: 1651-0091 EXPIRATION DATE: 03/31/2006
RESPS:48,000 HOURS:7,968 COSTS(000):$0
Andean Trade Preferences
FORMS: NONE
OMB NO: 1651-0092 EXPIRATION DATE: 03/31/2006
RESPS:500 HOURS:42 COSTS(000):$0
Application for Withdrawal of Bonded Stores for Fishing Vessels
and Certification of Use
FORMS: 5125
OMB NO: 1651-0093 EXPIRATION DATE: 03/31/2006
RESPS:5,700 HOURS:570 COSTS(000):$0
Declaration of Owner of Merchandise Obtained in Pursuance of
Purchase and Declaration of Importer of Record When Entry is
Made by an Agent
FORMS: 3347 3347-A
OMB NO: 1651-0094 EXPIRATION DATE: 03/31/2006
RESPS:1,500 HOURS:250 COSTS(000):$0
Declaration of a Person Abroad Who Receives and is Returning
Merchandise to the U.S.
FORMS: NONE
OMB NO: 1651-0095 EXPIRATION DATE: 03/31/2006
RESPS:1,471,625 HOURS:171,591 COSTS(000):$0
Textiles and Textile Products
FORMS: NONE
OMB NO: 1651-0096 EXPIRATION DATE: 03/31/2006
RESPS:21,660 HOURS:2,513 COSTS(000):$0
Transfer of Cargo to a Container Station
FORMS: NONE
OMB NO: 1651-0097 EXPIRATION DATE: 03/31/2006
RESPS:300 HOURS:75 COSTS(000):$0
Blanket Certification of Chemical Substances
FORMS: NONE
OMB NO: 1651-0098 EXPIRATION DATE: 03/31/2006
RESPS:120,500 HOURS:30,037 COSTS(000):$0
North American Free Trade Agreemtn (NAFTA) Certificate of Origin
FORMS: 434 446
OMB NO: 1651-0099 EXPIRATION DATE: 03/31/2006
RESPS:100 HOURS:50 COSTS(000):$0
Bond Procedures for Articles Subject to Exclusion Orders Issued
by the U.S. International Trade Commission.
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
99 178,740,466 26,686,702 $9,500
Transportation Security Administration
OMB NO: 1652-0001 EXPIRATION DATE: 08/31/2005
RESPS:780 HOURS:3,440 COSTS(000):$0
Imposition of Passenger Civil Aviation Security Service Fees
FORMS: NONE
OMB NO: 1652-0002 EXPIRATION DATE: 03/31/2005
RESPS:458 HOURS:512,426 COSTS(000):$23
Airport Security, Part 107
FORMS: NONE
OMB NO: 1652-0003 EXPIRATION DATE: 12/31/2003
RESPS:1,580 HOURS:8,855 COSTS(000):$0
Aircraft Operator Security, 14 CFR Part 108 Revision
FORMS: 1650-7 1650-17
OMB NO: 1652-0004 EXPIRATION DATE: 06/30/2003
RESPS:2,820 HOURS:664 COSTS(000):$0
Indirect Air Carrier Security -- 14 CFR Part 109
FORMS: N/A
OMB NO: 1652-0005 EXPIRATION DATE: 01/31/2006
RESPS:229 HOURS:5,193 COSTS(000):$0
Security Programs for Foreign Air Carriers
FORMS: 1650-17 1650-8
OMB NO: 1652-0006 EXPIRATION DATE: 06/30/2003
RESPS:1,305 HOURS:16,297 COSTS(000):$0
Employment Standards, FAR Part 107 and FAR Part 108
FORMS: NONE
OMB NO: 1652-0007 EXPIRATION DATE: 02/28/2005
RESPS:1 HOURS:5,193 COSTS(000):$0
Security Programs for Foreign Air Carriers, 14 CFR Part 129
FORMS: NONE
OMB NO: 1652-0010 EXPIRATION DATE: 08/31/2003
RESPS:4 HOURS:20 COSTS(000):$0
Transportation of Explosives from Canada to the United States
Via Commercial Motor Carriers and Rail
FORMS: NONE
OMB NO: 1652-0011 EXPIRATION DATE: 09/30/2003
RESPS:10,000 HOURS:10,000 COSTS(000):$0
Federal Flight Deck Officer Volunteer Questionnaire
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
9 17,177 562,088 $23
Bureau of Immigration and Customs Enforcement
OMB NO: 1653-0001 EXPIRATION DATE: 09/30/2003
RESPS:250 HOURS:63 COSTS(000):$0
Report of Complaint
FORMS: I-847
OMB NO: 1653-0002 EXPIRATION DATE: 01/31/2004
RESPS:12,500 HOURS:6,625 COSTS(000):$0
Application - Checkpoint Pre-enrolled Access Lane
FORMS: I-866
OMB NO: 1653-0003 EXPIRATION DATE: 10/31/2003
RESPS:270,410 HOURS:22,444 COSTS(000):$7,031
Application for Nonresident Alien's Mexican Border Crossing Card
FORMS: I-190
OMB NO: 1653-0004 EXPIRATION DATE: 07/31/2005
RESPS:25,000 HOURS:4,150 COSTS(000):$4,875
Application for Waiver of Passport and/or Visa
FORMS: I-193
OMB NO: 1653-0005 EXPIRATION DATE: 01/31/2005
RESPS:2,000 HOURS:500 COSTS(000):$0
Request for Cancellation of Public Charge Bond
FORMS: FORM-I-356
OMB NO: 1653-0006 EXPIRATION DATE: 07/31/2005
RESPS:85,000 HOURS:35,360 COSTS(000):$0
Application to Payoff or Discharge Alien Crewman
FORMS: I-408
OMB NO: 1653-0007 EXPIRATION DATE: 02/28/2005
RESPS:63,000 HOURS:10,458 COSTS(000):$1,008
Canadian Border Boat Landing Permit
FORMS: I-68
OMB NO: 1653-0008 EXPIRATION DATE: 02/28/2006
RESPS:170,000 HOURS:14,110 COSTS(000):$0
Guam Visa Waiver Information
FORMS: I-736
OMB NO: 1653-0009 EXPIRATION DATE: 10/31/2003
RESPS:50 HOURS:50 COSTS(000):$0
Visa Waiver Pilot Program Carrier Agreement
FORMS: I-775
OMB NO: 1653-0010 EXPIRATION DATE: 08/31/2003
RESPS:500,000 HOURS:583,000 COSTS(000):$12,740
Application - Alternative Inspection Services
FORMS: I-823
OMB NO: 1653-0011 EXPIRATION DATE: 09/30/2005
RESPS:14,424,380 HOURS:952,009 COSTS(000):$86,546
Arrival and Departure Record
FORMS: I-94
OMB NO: 1653-0012 EXPIRATION DATE: 12/31/2003
RESPS:25,000 HOURS:1,250 COSTS(000):$0
Arrival Record
FORMS: I-94A-OT
OMB NO: 1653-0013 EXPIRATION DATE: 02/28/2006
RESPS:200,000 HOURS:13,200 COSTS(000):$0
Arrival Departure Record (Transit Without Visa)
FORMS: I-94T
OMB NO: 1653-0014 EXPIRATION DATE: 06/30/2005
RESPS:4,000,000 HOURS:420,000 COSTS(000):$24,000
Visa Waiver Nonimmigrant Arrival/Departure Record
FORMS: I-94W
OMB NO: 1653-0015 EXPIRATION DATE: 10/31/2004
RESPS:433,000 HOURS:35,939 COSTS(000):$0
Alien Crewman Landing Permit
FORMS: I-95A I-95B
OMB NO: 1653-0016 EXPIRATION DATE: 08/31/2004
RESPS:65 HOURS:6,500 COSTS(000):$0
Screening Requirements of Carriers
FORMS: NONE
OMB NO: 1653-0017 EXPIRATION DATE: 01/31/2004
RESPS:1,500,400 HOURS:26,000 COSTS(000):$0
Inspection of Persons Applying for Admissions; Transit Without
Visa (TWOV) and International-to-International Agreements
FORMS: NONE
OMB NO: 1653-0018 EXPIRATION DATE: 10/31/2005
RESPS:75,000 HOURS:24,975 COSTS(000):$0
Sworn Statement of Refugee Applying for Admission to the United
States
FORMS: G-646
OMB NO: 1653-0019 EXPIRATION DATE: 07/31/2005
RESPS:10 HOURS:300 COSTS(000):$0
Emergency Federal Lw Enforcement Assistance
FORMS: NONE
OMB NO: 1653-0020 EXPIRATION DATE: 02/29/2004
RESPS:20,000 HOURS:3,320 COSTS(000):$0
Nonimmigrant Checkout Letter
FORMS: G-146
OMB NO: 1653-0021 EXPIRATION DATE: 11/30/2004
RESPS:10,000 HOURS:5,000 COSTS(000):$1,550
Application for Stay of Deportation or Removal
FORMS: I-246
OMB NO: 1653-0022 EXPIRATION DATE: 06/30/2003
RESPS:25,000 HOURS:12,500 COSTS(000):$0
Immigration Bond
FORMS: I-352
OMB NO: 1653-0023 EXPIRATION DATE: 06/30/2005
RESPS:600,000 HOURS:10,200 COSTS(000):$0
Baggage and Personal Effects of Detained Alien
FORMS: I-43
OMB NO: 1653-0024 EXPIRATION DATE: 10/31/2005
RESPS:100 HOURS:8 COSTS(000):$0
Guarantee of Payment
FORMS: I-510
OMB NO: 1653-0026 EXPIRATION DATE: 07/31/2005
RESPS:100 HOURS:100 COSTS(000):$0
Data Relalting to Beneficiary of Private Bill
FORMS: G-79A
OMB NO: 1653-0027 EXPIRATION DATE: 08/31/2005
RESPS:34,500 HOURS:41,938 COSTS(000):$3,787
Application for T nonimmigrant Status; Application for Immediate
Family Member of T-1 Recipient; & Declaration of Law Enforcement
Officer for Victim of Trafficking in Persons
FORMS: I-914 I-914-SUPP-A I-914-SUPP-B
OMB NO: 1653-0028 EXPIRATION DATE: 03/31/2005
RESPS:2,500 HOURS:625 COSTS(000):$0
Request for the Return of Original Document(s)
FORMS: G-884
OMB NO: 1653-0029 EXPIRATION DATE: 04/30/2005
RESPS:13 HOURS:331 COSTS(000):$0
Immigration User Fee
FORMS: NONE
OMB NO: 1653-0030 EXPIRATION DATE: 08/31/2005
RESPS:100,000 HOURS:25,000 COSTS(000):$0
Freedom of Information/Privacy Act Request
FORMS: G-639
OMB NO: 1653-0031 EXPIRATION DATE: 04/30/2003
RESPS:75,000 HOURS:4,950 COSTS(000):$0
Applicant
FORMS: G-942
OMB NO: 1653-0032 EXPIRATION DATE: 04/30/2005
RESPS:500,000 HOURS:41,500 COSTS(000):$0
Document Verification Request and Document Verification Request
Supplement
FORMS: G-845
OMB NO: 1653-0033 EXPIRATION DATE: 11/30/2003
RESPS:5,000 HOURS:7,915 COSTS(000):$0
Memorandum of Understanding to Participate in Employment
Eligibility Confirmation Pilot Program
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
32 23,158,278 2,310,320 $141,537
Directorate for Emergency Preparedness and Response (Undersecretary)
OMB NO: 1660-0001 EXPIRATION DATE: 04/30/2003
RESPS:50 HOURS:25 COSTS(000):$0
National Defense Executive Reserve Personal Qualification
Statement
FORMS: FEMA-85-3
OMB NO: 1660-0002 EXPIRATION DATE: 05/31/2003
RESPS:460,900 HOURS:171,148 COSTS(000):$0
Disaster Assistance Registration; Applicant
Statement/Authorization; Declaration of Applicant
FORMS: FEMA-90-69 FEMA-90-69A FEMA-90-69B FEMA-90-69C FEMA-90-69D
FEMA-90-69E
OMB NO: 1660-0003 EXPIRATION DATE: 10/31/2005
RESPS:9,844 HOURS:11,283 COSTS(000):$5,977
National Flood Insurance Program Biennial Report
FORMS: FEMA-81-28 FEMA-81-29 FEMA-81-29A
OMB NO: 1660-0004 EXPIRATION DATE: 12/31/2005
RESPS:100 HOURS:400 COSTS(000):$0
Application for Participation in the National Flood Insurance
Program
FORMS: 81-64
OMB NO: 1660-0005 EXPIRATION DATE: 12/31/2003
RESPS:77,634 HOURS:310,536 COSTS(000):$0
Claims for National Flood Insurance Program (NFIP)
FORMS: 81-40 81-41 81-41A 81-42 81-42A 81-43 81-44 81-57 81-58 81-59
OMB NO: 1660-0006 EXPIRATION DATE: 05/31/2003
RESPS:317,601 HOURS:31,718 COSTS(000):$16,856
National Flood Insurance Policy Forms
FORMS: 81-16 81-17 81-18 81-25 81-67
OMB NO: 1660-0007 EXPIRATION DATE: 07/31/2003
RESPS:65,000 HOURS:8,500 COSTS(000):$0
General Admissions Applications and General Admissions
Application Short Form
FORMS: FEMA-FORM-75-5 FEMA-FORM-75-5A
OMB NO: 1660-0008 EXPIRATION DATE: 12/31/2005
RESPS:54,695 HOURS:177,756 COSTS(000):$0
Post Construction Elevation Certificate/Floodproofing Certificate
FORMS: 81-31 81-65
OMB NO: 1660-0009 EXPIRATION DATE: 05/31/2003
RESPS:174 HOURS:13,224 COSTS(000):$0
The Declaration Process: Request for Damage Assessment, Federal
Disaster Assistance, Cost Share Adjustment, and Loans of the
Non-Federal Share
FORMS: NONE
OMB NO: 1660-0010 EXPIRATION DATE: 11/30/2004
RESPS:60 HOURS:90 COSTS(000):$0
Implementation of Coastal Barrier Resources Act
FORMS: NONE
OMB NO: 1660-0011 EXPIRATION DATE: 10/31/2004
RESPS:600 HOURS:450 COSTS(000):$0
Debt Collection Financial Statement
FORMS: 22-13
OMB NO: 1660-0012 EXPIRATION DATE: 09/30/2003
RESPS:520 HOURS:86 COSTS(000):$0
Request for Loan Information Verification
FORMS: FEMA-FORM-90-68
OMB NO: 1660-0013 EXPIRATION DATE: 12/31/2005
RESPS:20 HOURS:100 COSTS(000):$0
Exemption of State-Owned Properties Under Self-Insurance Plan
FORMS: NONE
OMB NO: 1660-0014 EXPIRATION DATE: 02/28/2006
RESPS:16 HOURS:24 COSTS(000):$0
Reimbursement for Cost of Fighting Fire on Federal Property
FORMS: NONE
OMB NO: 1660-0015 EXPIRATION DATE: 09/30/2005
RESPS:3,300 HOURS:11,583 COSTS(000):$0
Right to Submit Technical or Scientific Data to Correct Mapping
Deficiencies
FORMS: 81-87 81-87A 81-87B
OMB NO: 1660-0016 EXPIRATION DATE: 09/30/2005
RESPS:1,400 HOURS:19,600 COSTS(000):$0
Consultation with Local Officials to Assure Compliance with
Sections 110 and 206 of the Flood Disaster Protection Act
FORMS: 81-89 81-89A 81-89B 81-89C 81-89D 81-89E
OMB NO: 1660-0017 EXPIRATION DATE: 09/30/2005
RESPS:222,488 HOURS:94,243 COSTS(000):$0
Public Assistance Progress Report and Program Forms
FORMS: 90-49/90-91 90-91A/90-91B 90-91C/90-19D 90-120/90-121
90-123/90-124 90-125/90-126 90-127/90-128
OMB NO: 1660-0018 EXPIRATION DATE: 04/30/2003
RESPS:7,364 HOURS:814 COSTS(000):$0
Individual and Family Grants Program Administration Information
FORMS: 76-27 76-28 76-29 76-32 76-34 76-38
OMB NO: 1660-0019 EXPIRATION DATE: 07/31/2005
RESPS:7 HOURS:7 COSTS(000):$0
Claims of Federal Personnel for Personal Property Damage or Loss
FORMS: NONE
OMB NO: 1660-0020 EXPIRATION DATE: 09/30/2005
RESPS:1,260 HOURS:693 COSTS(000):$0
Write Your Own (WYO) Program
FORMS: NONE
OMB NO: 1660-0021 EXPIRATION DATE: 08/31/2004
RESPS:300 HOURS:300 COSTS(000):$0
National Fire Academy Executive Fire Officer Program Application
Form
FORMS: FORM-95-22
OMB NO: 1660-0022 EXPIRATION DATE: 02/28/2005
RESPS:940 HOURS:9,260 COSTS(000):$0
Community Rating System (CRS) Program - Application Worksheets
and Commentary
FORMS: FIMA-15 FIMA-15A
OMB NO: 1660-0023 EXPIRATION DATE: 11/30/2005
RESPS:5,000 HOURS:12,000 COSTS(000):$0
Effectiveness of a Community's Implementation of the NFIP
Community Assistance Program CAC and CAV Reports
FORMS: 81-69 81-68
OMB NO: 1660-0024 EXPIRATION DATE: 12/31/2005
RESPS:1 HOURS:160 COSTS(000):$0
Federal Assistance for Offsite Radiological Emergency Planning
FORMS: NONE
OMB NO: 1660-0025 EXPIRATION DATE: 02/29/2004
RESPS:4,936 HOURS:31,775 COSTS(000):$600
FEMA Grant Administration Forms
FORMS: FORMS-20-10 20-15 20-16A/B/C 20-17 20-18 20-19 20-20 76-10A
OMB NO: 1660-0026 EXPIRATION DATE: 12/31/2003
RESPS:26 HOURS:205 COSTS(000):$0
State Administrative Plan for the Hazardous Mitigation Grant
Program
FORMS: NONE
OMB NO: 1660-0027 EXPIRATION DATE: 09/30/2003
RESPS:26 HOURS:4,160 COSTS(000):$106
Hazard Mitigation Planning/State Hazard Mitigation Plan
FORMS: NONE
OMB NO: 1660-0028 EXPIRATION DATE: 08/31/2004
RESPS:10 HOURS:30 COSTS(000):$0
FEMA Contract Clause-Accessibility of Meetings to Persons with
Disabilities
FORMS: NONE
OMB NO: 1660-0029 EXPIRATION DATE: 12/31/2003
RESPS:1,200 HOURS:130 COSTS(000):$3,000
Approval and Coordination of Requirements to use the NETC for
Extracurricular Training Activities
FORMS: 75-10 75-11
OMB NO: 1660-0030 EXPIRATION DATE: 09/30/2005
RESPS:1,200 HOURS:367 COSTS(000):$3,000
Request for Site Inspection (FEMA Form 90-1); Landowner's
Authorization/Ingress-Egress Agreement (FF 90-31)
FORMS: 90-1 90-31
OMB NO: 1660-0031 EXPIRATION DATE: 11/30/2005
RESPS:25,000 HOURS:6,250 COSTS(000):$0
National Fire Academy Course Evalation Form (Used for Field/Off-
campus and State Weekend Programs)
FORMS: FEMA-95-45
OMB NO: 1660-0032 EXPIRATION DATE: 12/31/2003
RESPS:5,500 HOURS:1,375 COSTS(000):$0
National Fire Academy Resident Course Evaluation Form
FORMS: FEMA-FORM-95-20
OMB NO: 1660-0033 EXPIRATION DATE: 09/30/2003
RESPS:50 HOURS:163 COSTS(000):$0
Residential Basement Floodproofing Certificate
FORMS: FEMA-FORM-81-78
OMB NO: 1660-0034 EXPIRATION DATE: 12/31/2005
RESPS:4,000 HOURS:667 COSTS(000):$0
Emergency Mnagement Institute Resident Course Evaluation Form
FORMS: 95-41
OMB NO: 1660-0035 EXPIRATION DATE: 11/30/2004
RESPS:3,112 HOURS:4,668 COSTS(000):$90
Emergency Management Exercise Reporting System (EMERS)
FORMS: FORM-95-44
OMB NO: 1660-0036 EXPIRATION DATE: 08/31/2004
RESPS:96,720 HOURS:24,180 COSTS(000):$0
FEMA Response and Recovery Program Evaluation and Customer
Satisfaction Surveys
FORMS: FORM-86-26(MW)
OMB NO: 1660-0037 EXPIRATION DATE: 05/31/2005
RESPS:9,000 HOURS:21,600 COSTS(000):$1,080
Application Form for Single Lot or Structure Amendments to
National Flood Insurance Program Maps
FORMS: 81-92 81-92A
OMB NO: 1660-0038 EXPIRATION DATE: 12/31/2005
RESPS:5 HOURS:35 COSTS(000):$0
Write Your Own (WYO) Company Participation Criteria; New
Applicant
FORMS: NONE
OMB NO: 1660-0039 EXPIRATION DATE: 11/30/2005
RESPS:1,500 HOURS:375 COSTS(000):$0
National Fire Academy Long-term Course Evaluation Forms
FORMS: NONE
OMB NO: 1660-0040 EXPIRATION DATE: 09/30/2005
RESPS:20,000,000 HOURS:5,600,000 COSTS(000):$0
Standard Flood Hazard Determination Form
FORMS: 81-93
OMB NO: 1660-0041 EXPIRATION DATE: 06/30/2004
RESPS:6,490 HOURS:2,164 COSTS(000):$44
Federal Emergency Management Agency/Federal Insurance
FORMS: NONE
OMB NO: 1660-0042 EXPIRATION DATE: 07/31/2003
RESPS:7,500 HOURS:2,500 COSTS(000):$0
Make Your Mark on the Floodplain-High Water Mark Form
FORMS: FORM-81-101
OMB NO: 1660-0043 EXPIRATION DATE: 10/31/2003
RESPS:56 HOURS:3,360 COSTS(000):$0
Capability Assessment for Readiness (CAR)
FORMS: NONE
OMB NO: 1660-0044 EXPIRATION DATE: 10/31/2004
RESPS:2,320 HOURS:580 COSTS(000):$0
Emergency Management Institute Follow-up Evaluation Survey
FORMS: 95-56
OMB NO: 1660-0045 EXPIRATION DATE: 12/31/2005
RESPS:1,500 HOURS:4,500 COSTS(000):$98
Inspection of Insured Structures by Communities
FORMS: NONE
OMB NO: 1660-0046 EXPIRATION DATE: 02/29/2004
RESPS:90,000 HOURS:1,500 COSTS(000):$26
EMI Independent Study Course Enrollment Application
FORMS: FEMA-FORM-95-23
OMB NO: 1660-0047 EXPIRATION DATE: 02/29/2004
RESPS:56 HOURS:182 COSTS(000):$0
Request for Federal Assistance Form - How to Process Mission
Assignments in Federal Disaster Operations
FORMS: FORM-90-129
OMB NO: 1660-0048 EXPIRATION DATE: 05/31/2004
RESPS:30,445 HOURS:60,182 COSTS(000):$1,021
Supplemental Property Acquisition and Elevation Assistance
FORMS: SF-424 FEMA-20-10 FEMA-20-15 FEMA-20-16 FEMA-20-16B FEMA-20-16C
SF-LLL
OMB NO: 1660-0049 EXPIRATION DATE: 02/28/2005
RESPS:22,000 HOURS:17,000 COSTS(000):$0
Notice of Loss- Cerro Grande Fire Assistance Act
FORMS: FFCG-1
OMB NO: 1660-0050 EXPIRATION DATE: 12/31/2003
RESPS:300 HOURS:235 COSTS(000):$0
Closed-Basin Lake Endorsement
FORMS: 81-42 81-42A 81-43
OMB NO: 1660-0051 EXPIRATION DATE: 05/31/2004
RESPS:18,000 HOURS:405,000 COSTS(000):$0
Proof of Loss Form - Cerro Grande Fire Assistance Claims
FORMS: CG-2
OMB NO: 1660-0052 EXPIRATION DATE: 12/31/2003
RESPS:178 HOURS:356 COSTS(000):$9
Project Impact Baseline Report and Progress Report
FORMS: NONE
OMB NO: 1660-0053 EXPIRATION DATE: 05/31/2004
RESPS:12 HOURS:18,000 COSTS(000):$0
Subrogration Notice and Proff of Loss - Cerro Grande Fire
Assistance Act
FORMS: CG-3
OMB NO: 1660-0054 EXPIRATION DATE: 12/31/2005
RESPS:25,000 HOURS:174,500 COSTS(000):$0
Assistance to Firefighters Grant Program-Grant Application
Supplemental Information
FORMS: FEMA-20-10 FEMA-20-16 FEMA-16A FEMA-16B FEMA-16C FEMA-20-20
OMB NO: 1660-0055 EXPIRATION DATE: 08/31/2003
RESPS:800 HOURS:2,400 COSTS(000):$0
Request for Mitigation Assistance-Cerro Grande Mitigation
Proposal
FORMS: FFCG-4
OMB NO: 1660-0056 EXPIRATION DATE: 02/28/2005
RESPS:400 HOURS:400 COSTS(000):$0
Small Business Notice and Proof of Loss
FORMS: FFCG-8
OMB NO: 1660-0057 EXPIRATION DATE: 08/31/2004
RESPS:555 HOURS:420 COSTS(000):$0
Chemical Stockpile Emergency Preparedness Program (CSEPP)
Program Evaluation and Customer Satisfaction Baseline Survey
FORMS: NONE
OMB NO: 1660-0058 EXPIRATION DATE: 11/30/2004
RESPS:1,029 HOURS:2,168 COSTS(000):$0
Fire Management Assistance Grant Program
FORMS: 90-58 SF-424 90-91 20-10 270
OMB NO: 1660-0059 EXPIRATION DATE: 10/31/2004
RESPS:78,448 HOURS:3,915 COSTS(000):$0
National Flood Insurance Telephone Response Center (TRC) and
Leads Application Program
FORMS: 81-95
OMB NO: 1660-0060 EXPIRATION DATE: 02/28/2005
RESPS:125 HOURS:157 COSTS(000):$0
Review of Local Mitigation Planning Intiatives and Practices
FORMS: NONE
OMB NO: 1660-0061 EXPIRATION DATE: 03/31/2005
RESPS:40,168 HOURS:29,948 COSTS(000):$0
Federal Assistance to Individuals and Households Program
FORMS: NONE
OMB NO: 1660-0062 EXPIRATION DATE: 10/31/2005
RESPS:556 HOURS:160,460 COSTS(000):$0
State/Local/Tribal Hazard Mitigation Plans Under Section 322 of
the Disaster Mitigation Act of 2000
FORMS: NONE
OMB NO: 1660-0063 EXPIRATION DATE: 10/31/2005
RESPS:789 HOURS:3,555 COSTS(000):$67
Management Costs
FORMS: SF424 20-10 20-16 20-16A 20-16C 20-20
OMB NO: 1660-0064 EXPIRATION DATE: 10/31/2005
RESPS:820 HOURS:215 COSTS(000):$0
Cerro Grande Arbitrator and Cerro Grande Claimant Questionnaries
FORMS: NONE
OMB NO: 1660-0065 EXPIRATION DATE: 08/31/2003
RESPS:1,150 HOURS:288 COSTS(000):$0
National Earthquake Hazards Reduction Program Review of Publica-
tions
FORMS: NONE
OMB NO: 1660-0066 EXPIRATION DATE: 05/31/2003
RESPS:20 HOURS:80 COSTS(000):$0
Citizen Corps Affiliate Programs and Organizations Application
FORMS: NONE
OMB NO: 1660-0067 EXPIRATION DATE: 06/30/2003
RESPS:162 HOURS:1,972 COSTS(000):$0
Fire Suppression Assistance Program
FORMS: SF-424 SF-270 FEMA-90-91 FEMA-20-10
OMB NO: 1660-0068 EXPIRATION DATE: 02/28/2006
RESPS:2,000 HOURS:1,182 COSTS(000):$0
Federal Hotel and Motel Fire Safety Declaration Form
FORMS: NONE
OMB NO: 1660-0069 EXPIRATION DATE: 03/31/2006
RESPS:1,700,000 HOURS:1,757,760 COSTS(000):$38,115
National Fire Incident reporting System (NFIRS) Version 4.1 and
Version 5.0
FORMS: 4.1-NFIRS-1 NFIRS-2 NFIRS-3 NFIRS-4 NFIRS-5 NFIRS-HMI
5.0-NFIRS-FORMS NO.-1-12
OMB NO: 1660-0070 EXPIRATION DATE: 03/31/2006
RESPS:17,000 HOURS:7,083 COSTS(000):$0
National Fire Department Census
FORMS: 75-100
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
70 23,429,438 9,232,042 $70,089
AGENCY TOTALS:
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
397 320,640,956 76,432,668 $1,514,190
Department of Housing and Urban Development
Office of the Secretary
OMB NO: 2501-0009 EXPIRATION DATE: 04/30/2005
RESPS:20,000 HOURS:10,000 COSTS(000):$0
Record of Employee Interview
FORMS: HUD-11
OMB NO: 2501-0014 EXPIRATION DATE: 12/31/2003
RESPS:10,794,339 HOURS:365,858 COSTS(000):$0
Restrictions on Assistance to Noncitizens (FR-2383)
FORMS: NONE
OMB NO: 2501-0017 EXPIRATION DATE: 03/31/2005
RESPS:1 HOURS:1 COSTS(000):$0
HUD Alternative for SF 424 Forms, Application for Federal
Assistance and Attendent forms
FORMS: HUD-424 HUD-424-B HUD-424-C HUD-424-CB HUD-424-F
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
3 10,814,340 375,859 $0
Office of Housing
OMB NO: 2502-0001 EXPIRATION DATE: 04/30/2003
RESPS:8,000 HOURS:64,000 COSTS(000):$0
Personal Financial and Credit Statement -- HUD-92417
FORMS: HUD-92417
OMB NO: 2502-0005 EXPIRATION DATE: 05/31/2003
RESPS:4,130 HOURS:3,438 COSTS(000):$0
Application for Approval - FHA Lender and/or Ginnie Mae
mortgage-Backed Securities Issuer Branch Office Notification -
Title I/Title II
FORMS: HUD-11701 HUD-92001 HUD-92001-B
OMB NO: 2502-0010 EXPIRATION DATE: 06/30/2005
RESPS:1,500 HOURS:750 COSTS(000):$3,000
Land Survey Report for Insured Multifamily Projects
FORMS: HUD-2457
OMB NO: 2502-0011 EXPIRATION DATE: 01/31/2004
RESPS:4,000 HOURS:20,300 COSTS(000):$0
Request for Construction Change
FORMS: HUD-92437 HUD-92442 HUD-92442A HUD-92442-CA HUD-92442-A-CA
HUD-92441
OMB NO: 2502-0012 EXPIRATION DATE: 11/30/2003
RESPS:16,000 HOURS:5,280 COSTS(000):$0
Rent Schedule - Low Rent Housing
FORMS: HUD-92458
OMB NO: 2502-0016 EXPIRATION DATE: 02/29/2004
RESPS:465 HOURS:465 COSTS(000):$0
Final Endorsement of Credit Instrument
FORMS: HUD-92023
OMB NO: 2502-0018 EXPIRATION DATE: 05/31/2003
RESPS:525 HOURS:1,050 COSTS(000):$0
Advance of Escrow Funds
FORMS: HUD-92464
OMB NO: 2502-0025 EXPIRATION DATE: 06/30/2003
RESPS:300 HOURS:150 COSTS(000):$0
Cooperative Membership Exhibit
FORMS: HUD-93203
OMB NO: 2502-0028 EXPIRATION DATE: 12/31/2005
RESPS:12,000 HOURS:72,000 COSTS(000):$0
Contractor's Requisition - Project Mortgages
FORMS: HUD-92448
OMB NO: 2502-0029 EXPIRATION DATE: 07/31/2004
RESPS:6,300 HOURS:168,280 COSTS(000):$0
Application for Multifamily Housing Project
FORMS: HUD-92013 HUD-92013-SUPP HUD-92013-NHICP
OMB NO: 2502-0036 EXPIRATION DATE: 10/31/2005
RESPS:10,000 HOURS:10,000 COSTS(000):$0
Request for Credit Approval of Substitute Mortgagor
FORMS: HUD-92210
OMB NO: 2502-0041 EXPIRATION DATE: 01/31/2004
RESPS:1,935 HOURS:322 COSTS(000):$0
Multifamily Default Status
FORMS: HUD-92426
OMB NO: 2502-0044 EXPIRATION DATE: 08/31/2003
RESPS:925 HOURS:10,200 COSTS(000):$0
Contractor's and/or Mortgagor's Cost Breakdown Contractor's
Certificate of Actual Cost Mortgagor's Certificate of Actual Cost
FORMS: HUD-2328 HUD-92330-A HUD-2205-A
OMB NO: 2502-0047 EXPIRATION DATE: 10/31/2005
RESPS:5,000 HOURS:2,500 COSTS(000):$0
Construction Complaint - Request for Financial Assistance
FORMS: HUD-92556
OMB NO: 2502-0057 EXPIRATION DATE: 10/31/2005
RESPS:270 HOURS:90 COSTS(000):$0
Application for Eligibility as a Nonprofit Corporation
FORMS: HUD-3433 HUD-3434 HUD-3435
OMB NO: 2502-0058 EXPIRATION DATE: 01/31/2004
RESPS:1,500 HOURS:3,000 COSTS(000):$0
Financial Statement of Corporate Applicant for Cooperative
Housing Mortgage
FORMS: HUD-93232-A
OMB NO: 2502-0059 EXPIRATION DATE: 07/31/2004
RESPS:1,000,000 HOURS:235,025 COSTS(000):$0
Application for FHA Insured Mortgage (Addendum to Uniform
Residential Loan Application/Mortgage Credit Analysis
FORMS: HUD-92900-A HUD-92900-B HUD-92900-WS HUD-92900-PUR HUD-92561
HUD-92544
OMB NO: 2502-0060 EXPIRATION DATE: 03/31/2006
RESPS:7,200 HOURS:1,440 COSTS(000):$0
Monthly/Quarterly Single Family Delinquent Loan Reporting
FORMS: HUD-92068-A
OMB NO: 2502-0081 EXPIRATION DATE: 03/31/2006
RESPS:8,400 HOURS:5,250 COSTS(000):$0
Mortgagee's Cert./Application/Monthly Summary of Assistance
Payments
FORMS: HUD-300 HUD-93102
OMB NO: 2502-0082 EXPIRATION DATE: 06/30/2004
RESPS:100,073 HOURS:97,175 COSTS(000):$0
Recertification of Family Income and Composition, Section 235(b)
and Statistical Report Section 235(b), (i) and (j)
FORMS: HUD-93101 HUD-93101A
OMB NO: 2502-0086 EXPIRATION DATE: 09/30/2003
RESPS:32,500 HOURS:3,025 COSTS(000):$0
Monthly Report of Excess Income
FORMS: HUD-93104
OMB NO: 2502-0094 EXPIRATION DATE: 02/28/2006
RESPS:7,600 HOURS:3,900 COSTS(000):$0
Assistance Payment Contract - Notice of (1) Termination, (2)
Suspension, or (3) Reinstatement
FORMS: HUD-93114
OMB NO: 2502-0097 EXPIRATION DATE: 03/31/2004
RESPS:5,000 HOURS:1,000 COSTS(000):$0
Application for Insurance of Advance of Mortgage Proceeds
FORMS: HUD-92403
OMB NO: 2502-0098 EXPIRATION DATE: 08/31/2005
RESPS:800 HOURS:800 COSTS(000):$0
Personal Financial Statement
FORMS: HUD-56142
OMB NO: 2502-0108 EXPIRATION DATE: 01/31/2004
RESPS:48,000 HOURS:168,000 COSTS(000):$0
Monthly Reports for Establishing Income
FORMS: HUD-93479 93480 93481
OMB NO: 2502-0112 EXPIRATION DATE: 03/31/2005
RESPS:500 HOURS:4,000 COSTS(000):$0
Mortgagor's Certificate of Actual Cost
FORMS: HUD-92330
OMB NO: 2502-0118 EXPIRATION DATE: 02/29/2004
RESPS:4,300 HOURS:2,150 COSTS(000):$0
Previous Participation Certification
FORMS: HUD-2530
OMB NO: 2502-0141 EXPIRATION DATE: 09/30/2005
RESPS:15 HOURS:91 COSTS(000):$0
Mortgage Insurance for Cooperative and Condominium Housing
FORMS: HUD-93201
OMB NO: 2502-0178 EXPIRATION DATE: 04/30/2005
RESPS:1,120 HOURS:4,480 COSTS(000):$0
Management Reviews of Multifamily Housing Projects
FORMS: HUD-9834
OMB NO: 2502-0182 EXPIRATION DATE: 11/30/2003
RESPS:725,766 HOURS:284,110 COSTS(000):$0
Applications for Housing Assistance Payments
FORMS: HUD-52670 52670-A-PT.1 52670-A-PT.2 HUD-52671-A HUD-52671-B
HUD-52671-C HUD-52671-D
OMB NO: 2502-0187 EXPIRATION DATE: 12/31/2005
RESPS:6,336 HOURS:3,168 COSTS(000):$0
Requisition for Disbursement of Sections 202 & 811 Capital
Advance/Loan Funds
FORMS: HUD-92403-CA HUD-92403-EH
OMB NO: 2502-0189 EXPIRATION DATE: 10/31/2004
RESPS:3,639,500 HOURS:909,875 COSTS(000):$0
Compliance Inspection Report - HUD 92051 Mortgagee's Assurance
of Completion - HUD-92300
FORMS: HUD-92051 HUD-92300
OMB NO: 2502-0192 EXPIRATION DATE: 04/30/2004
RESPS:50,000 HOURS:25,000 COSTS(000):$0
Description of Materials
FORMS: HUD-92005
OMB NO: 2502-0204 EXPIRATION DATE: 10/31/2004
RESPS:2,207,339 HOURS:2,008,457 COSTS(000):$0
Owner's Certification of Compliance with HUD Tenant Eligibility
and Rent Procedures
FORMS: HUD-50059
OMB NO: 2502-0210 EXPIRATION DATE: 02/29/2004
RESPS:50 HOURS:10 COSTS(000):$0
Certificate of Need for Health Facility and Assurance of
Enforcement of State Standards
FORMS: HUD-2576-HF
OMB NO: 2502-0233 EXPIRATION DATE: 05/31/2003
RESPS:15,232 HOURS:8,032 COSTS(000):$265
Manufactured Home Construction and Safety Standards Program
FORMS: HUD-101 -203 -203-B -301 -302 -303 -304
OMB NO: 2502-0235 EXPIRATION DATE: 08/31/2003
RESPS:12,000 HOURS:3,000 COSTS(000):$0
Reporting Requirements Associated with 24 CFR 203.508b and 24
CFR 235.1001 - Providing Information
FORMS: NONE
OMB NO: 2502-0243 EXPIRATION DATE: 05/31/2005
RESPS:136,435 HOURS:19,579 COSTS(000):$0
Interstate Land Sales Registration and Consumer Notification
FORMS: NONE
OMB NO: 2502-0253 EXPIRATION DATE: 01/31/2005
RESPS:1,383,997 HOURS:245,493 COSTS(000):$0
Manufactured Home Construction and Safety Standards Act
Reporting Requirements
FORMS: NONE
OMB NO: 2502-0259 EXPIRATION DATE: 05/31/2003
RESPS:900 HOURS:6,300 COSTS(000):$0
Management Review Report for Unsubsidized Multifamily Housing
Projects
FORMS: HUD-9838
OMB NO: 2502-0261 EXPIRATION DATE: 04/30/2005
RESPS:7,275 HOURS:3,100 COSTS(000):$0
Housing Counseling Program
FORMS: HUD-9900 HUD-9902 HUD-9908
OMB NO: 2502-0265 EXPIRATION DATE: 07/31/2003
RESPS:105,300,000 HOURS:6,500,000 COSTS(000):$0
Real Estate Settlement Procedures Act (RESPA) Disclosures
FORMS: HUD-1 HUD-1A
OMB NO: 2502-0267 EXPIRATION DATE: 12/31/2003
RESPS:400 HOURS:16,164 COSTS(000):$0
Application Submission Requirements - Section 202 Supportive
Housing for the Elderly
FORMS: HUD-92015-CA HUD-92041
OMB NO: 2502-0268 EXPIRATION DATE: 08/31/2003
RESPS:61,525 HOURS:17,388 COSTS(000):$0
Request for Occupied Conveyance
FORMS: HUD-9539
OMB NO: 2502-0275 EXPIRATION DATE: 04/30/2003
RESPS:350 HOURS:32,000 COSTS(000):$0
Application for the Transfer of Physical Assets
FORMS: HUD-92266
OMB NO: 2502-0301 EXPIRATION DATE: 03/31/2006
RESPS:592 HOURS:296 COSTS(000):$0
Application for Consent to Accept Deed-In-Lieu of Foreclosure
FORMS: NONE
OMB NO: 2502-0302 EXPIRATION DATE: 11/30/2005
RESPS:80 HOURS:3,200 COSTS(000):$0
Local Appeals to Single-Family Mortgage Limits
FORMS: NONE
OMB NO: 2502-0305 EXPIRATION DATE: 04/30/2003
RESPS:3,600 HOURS:4,350 COSTS(000):$0
Management Certifications and Management Entity Profile
FORMS: HUD-9832 HUD-9839-A HUD-9839-B HUD-9839-C
OMB NO: 2502-0306 EXPIRATION DATE: 06/30/2004
RESPS:1,127,580 HOURS:563,765 COSTS(000):$0
Single Family Property Disposition and Acquisition (Conveyance)
or Mortgaged Properties
FORMS: HUD-9516-A 9519 9519-A 9733 9544 9548 9548-A 9548-B 9548-C
OMB NO: 2502-0313 EXPIRATION DATE: 01/31/2005
RESPS:50 HOURS:2,200 COSTS(000):$0
Technical Suitability of Products Program Section 521 of the
National Housing Act
FORMS: HUD-92005
OMB NO: 2502-0314 EXPIRATION DATE: 11/30/2005
RESPS:16 HOURS:1,080 COSTS(000):$0
Loan Servicing of All Three Coinsurance Programs: Section
221(d), Section 223(f), and Section 232
FORMS: HUD-9815
OMB NO: 2502-0321 EXPIRATION DATE: 07/31/2004
RESPS:1,350 HOURS:10,800 COSTS(000):$0
Minimum Property Standards for Housing, HUD Handbook 4910.1
FORMS: NONE
OMB NO: 2502-0322 EXPIRATION DATE: 03/31/2004
RESPS:100,000 HOURS:7,000 COSTS(000):$0
Adjustable Rate Mortgages (ARMS)
FORMS: NONE
OMB NO: 2502-0324 EXPIRATION DATE: 04/30/2003
RESPS:12,500 HOURS:15,625 COSTS(000):$0
Budget-Based Rent Increase
FORMS: HUD-92457-A
OMB NO: 2502-0328 EXPIRATION DATE: 04/30/2003
RESPS:330,370 HOURS:95,125 COSTS(000):$0
Title I Property Improvement and Manufactured Home Loan -- 24
CFR 201
FORMS: HUD-637 HUD-27029 HUD-27030 HUD-55013 HUD-55014 HUD-56001
HUD-56001MH HUD-56002 HUD-56002MH HUD-56004/92802
OMB NO: 2502-0340 EXPIRATION DATE: 09/30/2005
RESPS:1,220 HOURS:610 COSTS(000):$0
Single Family Mortgage Insurance on Indian Reservations and
Other Restricted Lands
FORMS: NONE
OMB NO: 2502-0342 EXPIRATION DATE: 07/31/2004
RESPS:123,602 HOURS:28,671 COSTS(000):$0
Pet Ownership in Assisted Rental Housing for the Elderly or
Handicapped
FORMS: NONE
OMB NO: 2502-0349 EXPIRATION DATE: 06/30/2003
RESPS:280 HOURS:140 COSTS(000):$0
Certified Eligibility for Adjustments for Damage or Neglect
FORMS: NONE
OMB NO: 2502-0352 EXPIRATION DATE: 09/30/2003
RESPS:1,200 HOURS:600 COSTS(000):$0
Utility Allowance Adjustments
FORMS: NONE
OMB NO: 2502-0355 EXPIRATION DATE: 10/31/2004
RESPS:1,138 HOURS:1,138 COSTS(000):$0
Contract and Subcontract Activity Reporting for Housing's
Multifamily Programs - Minority Business Enterprise (MBE)
FORMS: HUD-2516
OMB NO: 2502-0358 EXPIRATION DATE: 09/30/2005
RESPS:1,770 HOURS:253 COSTS(000):$0
Single Family Mortgage Insurance on Hawaiian Homelands
FORMS: NONE
OMB NO: 2502-0369 EXPIRATION DATE: 01/31/2004
RESPS:17,100 HOURS:153,900 COSTS(000):$0
Uniform Physical Standards & Physical Inspection Requirements
for Certain HUD Housing, Administrative Process for Assessment
of Insured and Assisted Properties
FORMS: NONE
OMB NO: 2502-0382 EXPIRATION DATE: 02/29/2004
RESPS:15 HOURS:120 COSTS(000):$0
Housing Development Grant Program Project Settlement Procedures
FORMS: HUD-90024 HUD-90025 HUD-90026 HUD-90027 HUD-90028
OMB NO: 2502-0395 EXPIRATION DATE: 12/31/2005
RESPS:400 HOURS:2,030 COSTS(000):$0
Flexible Subsidy, Capital Improvement Loan Program
FORMS: HUD-9823A HUD-9824A HUD-9826 HUD-9835 HUD-9835A HUD-9835B
OMB NO: 2502-0404 EXPIRATION DATE: 08/31/2005
RESPS:1,000,000 HOURS:250,000 COSTS(000):$0
Requirements for Single Family Mortgage Instruments
FORMS: NONE
OMB NO: 2502-0412 EXPIRATION DATE: 01/31/2004
RESPS:300 HOURS:600 COSTS(000):$0
Lease and Sale of HUD-Acquired Single Family Properties for the
Homeless
FORMS: NONE
OMB NO: 2502-0414 EXPIRATION DATE: 02/29/2004
RESPS:807,500 HOURS:129,700 COSTS(000):$0
Mortgage Insurance Termination; Application for Premium Refund
or Distribute Share Payment
FORMS: HUD-27050-A HUD-27050-B
OMB NO: 2502-0415 EXPIRATION DATE: 05/31/2003
RESPS:118 HOURS:411 COSTS(000):$0
Multifamily Mortgage Insurance Benefits Claim
FORMS: HUD-2742 2744-A 2744-B 2744-C 2744-D 2744-E
OMB NO: 2502-0416 EXPIRATION DATE: 04/30/2003
RESPS:500 HOURS:63 COSTS(000):$0
Request for Termination of Multifamily Mortgage Insurance
FORMS: HUD-9807
OMB NO: 2502-0418 EXPIRATION DATE: 07/31/2005
RESPS:215 HOURS:107 COSTS(000):$0
Statement of Taxes
FORMS: HUD-434
OMB NO: 2502-0419 EXPIRATION DATE: 02/29/2004
RESPS:215 HOURS:18 COSTS(000):$0
Mortgagee's Application for Insurance Benefits (Multifamily
Mortgage)
FORMS: HUD-2747
OMB NO: 2502-0420 EXPIRATION DATE: 02/29/2004
RESPS:12 HOURS:72 COSTS(000):$0
Multifamily Coinsurance Claims Package, Section 223(f)
FORMS: HUD-27008 27009B 27009D 27009F
OMB NO: 2502-0422 EXPIRATION DATE: 07/31/2004
RESPS:2,800,000 HOURS:262,600 COSTS(000):$0
Mortgage Record Change
FORMS: NONE
OMB NO: 2502-0423 EXPIRATION DATE: 01/31/2004
RESPS:804,000 HOURS:40,200 COSTS(000):$0
Single Family Premium Collection Subsystem-Upfront
FORMS: NONE
OMB NO: 2502-0424 EXPIRATION DATE: 12/31/2004
RESPS:70 HOURS:18 COSTS(000):$0
Preauthorized Debits, HUD PAD Authorization
FORMS: HUD-92090
OMB NO: 2502-0427 EXPIRATION DATE: 02/29/2004
RESPS:215 HOURS:54 COSTS(000):$0
Mortgagee's Application for Partial Settlement (Multifamily
Mortgage)
FORMS: HUD-2537
OMB NO: 2502-0429 EXPIRATION DATE: 05/31/2003
RESPS:90,000 HOURS:119,700 COSTS(000):$0
Single Family Application for Insurance Benefits
FORMS: HUD-27011 A-B-C-D-E (2502-0523)
OMB NO: 2502-0436 EXPIRATION DATE: 01/31/2006
RESPS:12,000 HOURS:3,000 COSTS(000):$0
Mortgagee's Request for Extension of Time
FORMS: HUD-50012
OMB NO: 2502-0446 EXPIRATION DATE: 11/30/2005
RESPS:1,250 HOURS:2,500 COSTS(000):$0
Procedures for Appealing Section 8 Rent Adjustments
FORMS: NONE
OMB NO: 2502-0447 EXPIRATION DATE: 06/30/2003
RESPS:8,960 HOURS:47,400 COSTS(000):$0
Multifamily Housing Service Coordinator Program
FORMS: HUD-92456 HUD-50080-SCMF SF-269 SF-424 SF-424-B HUD-2880 SF-LLL
OMB NO: 2502-0460 EXPIRATION DATE: 01/31/2005
RESPS:186 HOURS:104 COSTS(000):$0
Reporting Requirements for the Auction of Section 221(g)(4)
Multifamily Mortgages
FORMS: HUD-93487 HUD-93487-A
OMB NO: 2502-0462 EXPIRATION DATE: 12/31/2003
RESPS:260 HOURS:10,481 COSTS(000):$0
Application Submission Requirements - Section 811 Supportive
Housing for Persons with Disabilities
FORMS: HUD-92016-CA SF-424 HUD-50070 HUD-50071 SF-LLL HUD-2880 HUD-2992
HUD-2991 HUD-92041 HUD-92043
OMB NO: 2502-0470 EXPIRATION DATE: 01/31/2006
RESPS:2,290 HOURS:3,485 COSTS(000):$0
Capital Advance Program Submission Requirements for Section 202
Housing for the Elderly and Section 811 Housing for Persons with
Disabilities
FORMS: HUD-90163-CA 90164-CA 90165-CA 90166-CA 90167-CA 90170-CA
90171-CA 90176-CA 90177-CA 91732-CA
OMB NO: 2502-0476 EXPIRATION DATE: 05/31/2003
RESPS:1,500 HOURS:55,950 COSTS(000):$0
Federally Assisted Low-Income Housing Drug Elimination Grants
FORMS: HUD-50080-DF-2B SF-269 SF-424 SF-424-A HUD-2880 SF-LLL
OMB NO: 2502-0483 EXPIRATION DATE: 02/28/2006
RESPS:500 HOURS:250 COSTS(000):$0
Repayment Agreement
FORMS: HUD-56146
OMB NO: 2502-0485 EXPIRATION DATE: 11/30/2004
RESPS:648 HOURS:1,013 COSTS(000):$0
Congregate Housing Services Program
FORMS: HUD-90006 HUD-90198 HUD-91180-A SF-269
OMB NO: 2502-0486 EXPIRATION DATE: 12/31/2003
RESPS:272,950 HOURS:65,870 COSTS(000):$0
Single Family Acquired Asset Management System (SAMS)
FORMS: SAMS-1100 1101 1103 1106 1106-C 1108 1110 1111 1111-A 1117
OMB NO: 2502-0493 EXPIRATION DATE: 01/31/2006
RESPS:3,500 HOURS:7,875 COSTS(000):$0
Master Appraisal Reports
FORMS: HUD-91322 HUD-91322.1 HUD-91322.2 HUD-91322.3
OMB NO: 2502-0494 EXPIRATION DATE: 06/30/2004
RESPS:1,200,000 HOURS:140,000 COSTS(000):$0
HUD Conditional Commitment/Direct Endorsement Statement of
Appraised Value
FORMS: HUD-92800.5B
OMB NO: 2502-0496 EXPIRATION DATE: 04/30/2003
RESPS:65,600 HOURS:16,400 COSTS(000):$0
Builder's Certification of Plans, Specifications, and Site
FORMS: HUD-92541
OMB NO: 2502-0505 EXPIRATION DATE: 11/30/2003
RESPS:26,000 HOURS:53,500 COSTS(000):$0
Comprehensive Needs Assessment (CNA)
FORMS: HUD-96001 96002 96003
OMB NO: 2502-0507 EXPIRATION DATE: 03/31/2005
RESPS:6,000 HOURS:9,000 COSTS(000):$0
AAF Rent Increase Requirement Pursuant to the Housing
Appropriations Act of 1994
FORMS: HUD-92273-S8
OMB NO: 2502-0512 EXPIRATION DATE: 12/31/2004
RESPS:750 HOURS:188 COSTS(000):$3
Automated Cleaning House (ACH) Program Application - Title I
Insurance Charge Payments System
FORMS: HUD-56150
OMB NO: 2502-0514 EXPIRATION DATE: 01/31/2006
RESPS:87 HOURS:5,632 COSTS(000):$87
The Federal National Mortgage Association (Fannie Mae) and the
Federal Home Loan Mortgage Corporation (Freddie Mac) Regulations
FORMS: NONE
OMB NO: 2502-0518 EXPIRATION DATE: 10/31/2004
RESPS:15 HOURS:960 COSTS(000):$1,200
Hospital, Section 242, Application for Project Mortgage Insurance
FORMS: HUD-92013-HOSP
OMB NO: 2502-0523 EXPIRATION DATE: 09/30/2005
RESPS:543,180 HOURS:135,795 COSTS(000):$0
Loss Mitigation Evaluation
FORMS: NONE
OMB NO: 2502-0525 EXPIRATION DATE: 10/31/2005
RESPS:54,000 HOURS:8,964 COSTS(000):$0
Builder's Certification/Guaranee and New Construction
Subterranean Termit Soil Treatment Record
FORMS: HUD-NPCA-99-A HUD-NPCA-99-B
OMB NO: 2502-0526 EXPIRATION DATE: 08/31/2004
RESPS:20 HOURS:400 COSTS(000):$0
Use of Materials Bulletins for the HUD Building Products
Standards and Certification Program
FORMS: NONE
OMB NO: 2502-0527 EXPIRATION DATE: 04/30/2004
RESPS:259,200 HOURS:319,450 COSTS(000):$0
203(K) Rehabilitation Mortgage Insurance
FORMS: HUD-92700 HUD-9746-A
OMB NO: 2502-0533 EXPIRATION DATE: 05/31/2003
RESPS:3,199 HOURS:371,652 COSTS(000):$0
Multifamily Housing Mortgage and Housing Assistance Restructuring
FORMS: NONE
OMB NO: 2502-0534 EXPIRATION DATE: 08/31/2005
RESPS:32,000 HOURS:6,800 COSTS(000):$0
Home Equity Conversion Mortgages (HECM): Consumer Protection
Measures Against Excessive Fees
FORMS: NONE
OMB NO: 2502-0535 EXPIRATION DATE: 05/31/2003
RESPS:45 HOURS:825 COSTS(000):$15
NOFA for Secondary Market for Non-Conforming Loans to Low Wealth
Borrowers Demonstration Program
FORMS: HUD-2880 HUD-50071 HUD-2992
OMB NO: 2502-0536 EXPIRATION DATE: 01/31/2006
RESPS:96,000 HOURS:19,200 COSTS(000):$0
Single Family Premium Collection Subsystem-Periodic (SFPCS-P)
FORMS: NONE
OMB NO: 2502-0537 EXPIRATION DATE: 08/31/2005
RESPS:9,000 HOURS:4,500 COSTS(000):$0
Informed Consumer Choice Disclosure Notice
FORMS: NONE
OMB NO: 2502-0538 EXPIRATION DATE: 04/30/2003
RESPS:1,215,000 HOURS:502,500 COSTS(000):$625
Fee or Roster Designation, HUD Conditions and Appraisal Report
FORMS: HUD-92563 HUD-92564-VC HUD-92564-HS HUD-92564-CN 1004 1004B
OMB NO: 2502-0539 EXPIRATION DATE: 04/30/2003
RESPS:1,800 HOURS:266,666 COSTS(000):$1,700
HMDA Loan/Application Register
FORMS: HUD HMDA/LAR
OMB NO: 2502-0540 EXPIRATION DATE: 10/31/2003
RESPS:15,750 HOURS:81,000 COSTS(000):$0
Application and Re-certification Packages for Approval of
Nonprofit Organizations in FHA Activities
FORMS: NONE
OMB NO: 2502-0541 EXPIRATION DATE: 02/29/2004
RESPS:130 HOURS:1,300 COSTS(000):$0
Lender Qualifications for Multifamily Accelerated Processing
(MAP)
FORMS: NONE
OMB NO: 2502-0542 EXPIRATION DATE: 08/31/2003
RESPS:260 HOURS:4,300 COSTS(000):$0
Assisted Living Conversion Program (ALCP)
FORMS: HUD-92045
OMB NO: 2502-0545 EXPIRATION DATE: 10/31/2004
RESPS:15 HOURS:1,200 COSTS(000):$0
Review of Health Care Facility Portfolios
FORMS: NONE
OMB NO: 2502-0546 EXPIRATION DATE: 06/30/2004
RESPS:4,000 HOURS:2,000 COSTS(000):$0
Home Equity Conversion Mortgage (HECM) Program; Insurance for
Mortgages to Refinance Existing HECMs (FR-4667)
FORMS: NONE
OMB NO: 2502-0547 EXPIRATION DATE: 12/31/2003
RESPS:750,000 HOURS:27,500 COSTS(000):$0
Owner of Record and Re-Sale Data to Preclude Predatory Lending
Practices (Property Flipping) on FHA Insured Mortgages
FORMS: NONE
OMB NO: 2502-0548 EXPIRATION DATE: 04/30/2005
RESPS:9,000 HOURS:5,250 COSTS(000):$0
FHA Fee Inspector Panel Application Package
FORMS: HUD-92563
OMB NO: 2502-0549 EXPIRATION DATE: 03/31/2006
RESPS:8,240 HOURS:4,120 COSTS(000):$0
HUD's Loss Mitigation Default Counseling Demonstration Program
FORMS: NONE
OMB NO: 2502-0550 EXPIRATION DATE: 04/30/2003
RESPS:30,000 HOURS:15,000 COSTS(000):$0
Inventory of Housing Units Designated for Elderly/Disabled
Persons
FORMS: HUD-90059
OMB NO: 2502-0551 EXPIRATION DATE: 10/31/2005
RESPS:20,774 HOURS:53,784 COSTS(000):$0
Multifamily Financial Management Template
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
116 126,715,580 14,920,097 $6,895
Government National Mortgage Association
OMB NO: 2503-0001 EXPIRATION DATE: 09/30/2003
RESPS:1,188 HOURS:297 COSTS(000):$0
Application for Commitment to Guarantee Mortgage-Backed
Securities
FORMS: HUD-11704
OMB NO: 2503-0004 EXPIRATION DATE: 07/31/2004
RESPS:263,340 HOURS:42,135 COSTS(000):$0
Issuer's Monthly Accounting Reports
FORMS: 11710-A 11710-B 11710-C 11710-D 11710-E
OMB NO: 2503-0009 EXPIRATION DATE: 10/31/2005
RESPS:31,482 HOURS:5,352 COSTS(000):$0
Schedule of Subscribers and Ginnie Mae Guaranty Agreement
FORMS: 11705
OMB NO: 2503-0010 EXPIRATION DATE: 08/31/2004
RESPS:31,540 HOURS:7,885 COSTS(000):$0
Schedule of Pooled Mortgages
FORMS: 11706
OMB NO: 2503-0015 EXPIRATION DATE: 06/30/2004
RESPS:263,340 HOURS:2,633 COSTS(000):$0
Issuer's Monthly Remittance Advice and Issuer's Monthly Serial
Note Remittance Advice
FORMS: HUD-11714 HUD-11714SN
OMB NO: 2503-0016 EXPIRATION DATE: 06/30/2005
RESPS:1,100 HOURS:187 COSTS(000):$0
Guaranty of Mortgage-backed Securities
FORMS: 11700 11702 11707
OMB NO: 2503-0017 EXPIRATION DATE: 01/31/2006
RESPS:4,154 HOURS:810 COSTS(000):$0
Ginnie Mae's Document Release Request ACH Debit Authorization,
Servicer's/Custodial Account, and Master Agreements
FORMS: 11708 11709 11709A 11715 11720
OMB NO: 2503-0018 EXPIRATION DATE: 04/30/2004
RESPS:31,540 HOURS:7,885 COSTS(000):$0
Prospectus
FORMS: 11712/11712-11 11717/11717-11 1724 11728/11728-11 1731 1734
11747 11747-11 11772-11
OMB NO: 2503-0026 EXPIRATION DATE: 07/31/2005
RESPS:1,184 HOURS:4,736 COSTS(000):$0
Quarterly Loan Level Reporting
FORMS: NONE
OMB NO: 2503-0032 EXPIRATION DATE: 08/31/2003
RESPS:150 HOURS:38 COSTS(000):$0
Generic Customer Satisfaction Surveys for Business Partners and
Multiclass Program Participants
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
10 629,018 71,958 $0
Office of Community Planning and Development
OMB NO: 2506-0016 EXPIRATION DATE: 04/30/2005
RESPS:36,800 HOURS:31,000 COSTS(000):$0
Application for Relocation/Displacement Assistance
FORMS: HUD-40054 40055 40056 40057 40058 40061 40072
OMB NO: 2506-0020 EXPIRATION DATE: 05/31/2005
RESPS:800 HOURS:6,400 COSTS(000):$0
HUD-Administered Small Cities Program Performance Assessment
Report
FORMS: HUD-4052
OMB NO: 2506-0042 EXPIRATION DATE: 04/30/2003
RESPS:150 HOURS:350 COSTS(000):$0
Urban Homesteading Program
FORMS: NONE
OMB NO: 2506-0077 EXPIRATION DATE: 01/31/2004
RESPS:1 HOURS:434,040 COSTS(000):$0
24 CFR Part 570 - Community Development Block Grant Entitlement
Program
FORMS: NONE
OMB NO: 2506-0080 EXPIRATION DATE: 01/31/2004
RESPS:900 HOURS:1,571 COSTS(000):$0
Rental Rehabilitation Program
FORMS: HUD-40014 40014B 40021 40070 40014-A 40018 40018-A 40022
OMB NO: 2506-0085 EXPIRATION DATE: 10/31/2004
RESPS:50 HOURS:107,400 COSTS(000):$0
State Community Development Block Grant (CDBG) Program
FORMS: NONE
OMB NO: 2506-0087 EXPIRATION DATE: 11/30/2004
RESPS:18,785 HOURS:11,271 COSTS(000):$0
Environmental Review Procedures for Entities Assuming HUD
Environmental Review Responsibilities
FORMS: HUD-7015.15
OMB NO: 2506-0112 EXPIRATION DATE: 06/30/2003
RESPS:4,620 HOURS:203,280 COSTS(000):$0
Continuum of Care Homeless Assistance Application
FORMS: HUD-40076-COC HUD-40076-2 HUD-40085-2
OMB NO: 2506-0117 EXPIRATION DATE: 08/31/2005
RESPS:2,200 HOURS:549,925 COSTS(000):$2,150
Consolidated Plan
FORMS: NONE
OMB NO: 2506-0121 EXPIRATION DATE: 04/30/2005
RESPS:80,000 HOURS:260,000 COSTS(000):$0
Relocation and Real Property Acquisition, Recordkeeping
Requirements Under the Uniform Relocation Assistance and Real
Property Acquisition Policies Act of 1979
FORMS: NONE
OMB NO: 2506-0122 EXPIRATION DATE: 02/29/2004
RESPS:1,115 HOURS:42,700 COSTS(000):$0
Historically Black Colleges and Universities (HBCUs)
FORMS: HUD-40076HBCU
OMB NO: 2506-0128 EXPIRATION DATE: 08/31/2003
RESPS:2,528 HOURS:15,490 COSTS(000):$0
HOPE for Homeownership of Single Family Homes Program (HOPE 3)
FORMS: HUD-40086-B 40102-B 40103 40104 40105
OMB NO: 2506-0133 EXPIRATION DATE: 11/30/2003
RESPS:410 HOURS:28,635 COSTS(000):$0
Housing Opportunities for Persons with AIDS (HOPWA) Program:
Aplication for competitive grants award; annual progress report
for competitive
FORMS: HUD-40110-B HUD-40110-C
OMB NO: 2506-0142 EXPIRATION DATE: 09/30/2003
RESPS:300 HOURS:9,250 COSTS(000):$0
Youthbuild Program
FORMS: HUD-40200 -40201 -40202 -40203 SF-1199A HUD-27054
OMB NO: 2506-0145 EXPIRATION DATE: 06/30/2003
RESPS:1 HOURS:200,000 COSTS(000):$0
Competitive Homeless Assistance Program Annual Progress Report
(APR)
FORMS: HUD-40118
OMB NO: 2506-0148 EXPIRATION DATE: 12/31/2004
RESPS:97 HOURS:6,111 COSTS(000):$0
Third Round Designation of Seven Urban Empowerment Zones
FORMS: HUD-40003
OMB NO: 2506-0151 EXPIRATION DATE: 08/31/2004
RESPS:300 HOURS:2,700 COSTS(000):$0
24 CFR Part 55, Floodplain Management
FORMS: NONE
OMB NO: 2506-0153 EXPIRATION DATE: 08/31/2004
RESPS:100 HOURS:8,160 COSTS(000):$0
Economic Development Initiative (EDI) & Brownfields Economic
Development Initiative (BEDI) Grant Programs
FORMS: HUD-40076
OMB NO: 2506-0159 EXPIRATION DATE: 03/31/2005
RESPS:800 HOURS:10,200 COSTS(000):$0
Loan Guarantee Recovery Fund Established Pursuant to the Church
Arson Prevention Act of 1996
FORMS: SF-424 HUD-40076-LGA
OMB NO: 2506-0165 EXPIRATION DATE: 07/31/2004
RESPS:580 HOURS:18,560 COSTS(000):$52
Disaster Recovery Grant Reporting System
FORMS: NONE
OMB NO: 2506-0166 EXPIRATION DATE: 11/30/2004
RESPS:3,688 HOURS:23,264 COSTS(000):$0
Technical Assistance for Community Planning and Development
Programs
FORMS: SF-424 SF-424B SF-LLL HUD-424M HUD-50070 HUD-50071 HUD-2880
HUD-2992
OMB NO: 2506-0169 EXPIRATION DATE: 11/30/2003
RESPS:1,240 HOURS:18,940 COSTS(000):$0
Rural Housing and Economic Development Program
FORMS: SF-424
OMB NO: 2506-0170 EXPIRATION DATE: 10/31/2005
RESPS:58 HOURS:3,545 COSTS(000):$0
CDBG Urban County/New York Towns Qualification/Requalification
Process
FORMS: NONE
OMB NO: 2506-0171 EXPIRATION DATE: 03/31/2005
RESPS:245,539 HOURS:379,941 COSTS(000):$0
HOME Investment Partnerships Program
FORMS: HUD-40093 HUD-40093A HUD-40107 HUD-40107-A
OMB NO: 2506-0173 EXPIRATION DATE: 12/31/2004
RESPS:94 HOURS:9,360 COSTS(000):$0
Designation of Round III Empowerment Zones and Renewal
Communities
FORMS: HUD-40005
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
25 401,156 2,382,093 $2,202
Real Estate Assessment Center
OMB NO: 2507-0001 EXPIRATION DATE: 11/30/2003
RESPS:269,091 HOURS:82,903 COSTS(000):$0
Customer Service and Satisfaction Survey
FORMS: NONE
OMB NO: 2507-0003 EXPIRATION DATE: 05/31/2003
RESPS:732,300 HOURS:37,500 COSTS(000):$0
Tenant Assessment Subsystem (TASS) computer matching income
verification
FORMS: 50073 50074
OMB NO: 2507-0004 EXPIRATION DATE: 01/31/2005
RESPS:7,000 HOURS:21,000 COSTS(000):$0
Electronic Financial Submissions for Certain HUD Lenders (HUD
Approved Nonsupervised Lenders, Nonsupervised Mortgagees, and
Loan Correspondents)
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
3 1,008,391 141,403 $0
Office of the General Counsel
OMB NO: 2510-0008 EXPIRATION DATE: 11/30/2004
RESPS:213 HOURS:213 COSTS(000):$0
Information request to owners of HUD-assisted multifamily
housing in Boston, pursuant to Section III.A of Consent Decree
in N.A.A.C.P., Boston Chapter v. Martinez
FORMS: HUD-23002
OMB NO: 2510-0011 EXPIRATION DATE: 06/30/2003
RESPS:16,900 HOURS:40,560 COSTS(000):$0
Accountability in the Provision of HUD Assistance
Applicant/Recipient Disclosure/Update
FORMS: HUD-2880
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
2 17,113 40,773 $0
Policy Development and Research
OMB NO: 2528-0013 EXPIRATION DATE: 10/31/2004
RESPS:48,000 HOURS:4,000 COSTS(000):$0
Survey of Market Absorption of New Apartment Buildings
FORMS: H-31 SOMA-1
OMB NO: 2528-0017 EXPIRATION DATE: 04/30/2004
RESPS:47,300 HOURS:30,517 COSTS(000):$0
American Housing Survey (AHS) - 2001 National Survey
FORMS: AHS-26 AHS-27 AHS-28
OMB NO: 2528-0029 EXPIRATION DATE: 09/30/2003
RESPS:12,960 HOURS:6,480 COSTS(000):$0
Survey of New Manufactured (Mobile) Home Placements
FORMS: C-MH-9A
OMB NO: 2528-0142 EXPIRATION DATE: 10/31/2003
RESPS:46,000 HOURS:11,454 COSTS(000):$0
Section 8 Random Digit Dialing Fair Market Rent Surveys
FORMS: NONE
OMB NO: 2528-0165 EXPIRATION DATE: 06/30/2004
RESPS:58 HOURS:1,392 COSTS(000):$0
Low Income Housing Tax Credit Database
FORMS: NONE
OMB NO: 2528-0170 EXPIRATION DATE: 02/29/2004
RESPS:187,000 HOURS:41,385 COSTS(000):$0
Customer-Survey of Households Living in Federally Assisted Units
FORMS: NONE
OMB NO: 2528-0175 EXPIRATION DATE: 10/31/2003
RESPS:180 HOURS:3,150 COSTS(000):$0
Community Development Work Study Program
FORMS: HUD-424 HUD-424B HUD-2880 HUD-2993 HUD-2994 HUD-3007 HUD-30013
HUD-30014 HUD-30015
OMB NO: 2528-0180 EXPIRATION DATE: 04/30/2003
RESPS:160 HOURS:14,208 COSTS(000):$0
Community Outreach Partnership Centers Program (COPC)
FORMS: HUD-30001 HUD-30002 HUD-30003
OMB NO: 2528-0198 EXPIRATION DATE: 02/28/2006
RESPS:100 HOURS:4,160 COSTS(000):$0
Hispanic-Serving Institutions Assisting Communities
FORMS: HUD-424 HUD-424-B HUD-424-C HUD2880 HUD2990 HUD2991 HUD2992
HUD2993 HUD2994 HUD3004
OMB NO: 2528-0206 EXPIRATION DATE: 05/31/2003
RESPS:36 HOURS:1,824 COSTS(000):$0
Alaska Native / Native Hawaiian Institutions Assisting
Communities (AN/NHIC)
FORMS: HUD-30005
OMB NO: 2528-0209 EXPIRATION DATE: 08/31/2003
RESPS:100 HOURS:33 COSTS(000):$0
Assessment of the American Housing Survey - Metropolitan Sample
(AHS-MS)
FORMS: NONE
OMB NO: 2528-0211 EXPIRATION DATE: 10/31/2003
RESPS:2,418 HOURS:605 COSTS(000):$0
HUD 2020 Partners Survey
FORMS: NONE
OMB NO: 2528-0212 EXPIRATION DATE: 10/31/2003
RESPS:1,500 HOURS:175 COSTS(000):$0
Fair Housing Literacy Survey
FORMS: NONE
OMB NO: 2528-0213 EXPIRATION DATE: 01/31/2004
RESPS:125 HOURS:2,710 COSTS(000):$0
Doctoral Dissertation Research Grant Program
FORMS: NONE
OMB NO: 2528-0214 EXPIRATION DATE: 09/30/2004
RESPS:120 HOURS:3,320 COSTS(000):$0
HUD Urban Scholars Fellowship Program
FORMS: HUD-424
OMB NO: 2528-0215 EXPIRATION DATE: 10/31/2004
RESPS:52 HOURS:3,208 COSTS(000):$0
Tribal Colleges and Universities Program
FORMS: HUD-50070 50071 SF-424 HUD-424-M SF-424B SF-LLL HUD-2880
OMB NO: 2528-0216 EXPIRATION DATE: 04/30/2004
RESPS:125 HOURS:2,710 COSTS(000):$0
Early Doctoral Student Grant Program
FORMS: NONE
OMB NO: 2528-0217 EXPIRATION DATE: 10/31/2004
RESPS:1,595 HOURS:661 COSTS(000):$0
An Assessment of Third-Party Economic Development Loans Funded
Through HUD's Community Planning and Development Programs
FORMS: NONE
OMB NO: 2528-0218 EXPIRATION DATE: 10/31/2004
RESPS:10,277 HOURS:13,933 COSTS(000):$0
Data Collection for The Interim Impact Evaluation for the Moving
to Opportunity Demonstration
FORMS: NONE
OMB NO: 2528-0219 EXPIRATION DATE: 01/31/2005
RESPS:200 HOURS:400 COSTS(000):$0
Information collection to establish the needs for and uses of
electronic permitting systems in use in building code offices in
communities
FORMS: NONE
OMB NO: 2528-0220 EXPIRATION DATE: 01/31/2005
RESPS:480 HOURS:160 COSTS(000):$0
HUD Mobility-Impaired Tenant Survey
FORMS: NONE
OMB NO: 2528-0221 EXPIRATION DATE: 06/30/2005
RESPS:216 HOURS:100 COSTS(000):$0
Housing Choice Voucher Tenant Accessibility Study: 2002-2003
FORMS: NONE
OMB NO: 2528-0222 EXPIRATION DATE: 08/31/2005
RESPS:595 HOURS:595 COSTS(000):$0
Mail Survey of HOME Investment Partnership Program Administrators
FORMS: NONE
OMB NO: 2528-0225 EXPIRATION DATE: 05/31/2003
RESPS:45 HOURS:101 COSTS(000):$0
Survey to Determine the Utility of Proposed RESPA Good Faith
Estimate and Guaranteed Mortgage Package Agreement
FORMS: NONE
OMB NO: 2528-0227 EXPIRATION DATE: 08/31/2003
RESPS:80 HOURS:1,700 COSTS(000):$0
Notice of Funding Availability for Research on Socioeconomic
Change in Cities
FORMS: HUD-424 HUD-424-B HUD-424-CB CBW STND.FORM-LLL HUD-2880 HUD-2993
HUD-2994 HUD-2993
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
25 359,722 148,981 $0
Office of Fair Housing and Equal Opportunity
OMB NO: 2529-0011 EXPIRATION DATE: 09/30/2004
RESPS:10,750 HOURS:7,148 COSTS(000):$0
Housing Discrimination Information Form 903.1 and the Housing
Discrimination Form HUD-903 (English) and HUD-903A (Spanish)
FORMS: HUD-903 HUD-903A
OMB NO: 2529-0013 EXPIRATION DATE: 09/30/2003
RESPS:3,006 HOURS:9,018 COSTS(000):$0
Affirmative Fair Housing Marketing Plan, Form HUD-935.2
FORMS: HUD-935.2
OMB NO: 2529-0033 EXPIRATION DATE: 08/31/2003
RESPS:1,186 HOURS:48,472 COSTS(000):$0
Fair Housing Initiative Program (FHIP) Grant Application
FORMS: 40076-FHIP 424 424B 424C 424CB 424CBW 2880 2990-2991 2993-2994
OMB-SF-LLL
OMB NO: 2529-0043 EXPIRATION DATE: 06/30/2004
RESPS:58,593 HOURS:117,186 COSTS(000):$0
Economic Opportunities for Low-and Very Low-Income Persons
FORMS: HUD-60002 HUD-958
OMB NO: 2529-0046 EXPIRATION DATE: 06/30/2003
RESPS:12,000 HOURS:5,500 COSTS(000):$0
Final Regulations Implementing Housing for Older Persons Act of
(FR-4094-F-02) 1995 (HOPA)
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
5 85,535 187,324 $0
Office of Administration
OMB NO: 2535-0091 EXPIRATION DATE: 04/30/2003
RESPS:12 HOURS:45,600 COSTS(000):$0
HUD Acquisition Regulation (HUDAR) (48 CFR 24)
FORMS: HUD-770
OMB NO: 2535-0102 EXPIRATION DATE: 01/31/2004
RESPS:237,200 HOURS:40,324 COSTS(000):$0
Request Voucher for Grant Payment and LOCCS Voice Response
System Access Authorization
FORMS: HUD-27053 HUD-27054
OMB NO: 2535-0106 EXPIRATION DATE: 11/30/2003
RESPS:3,169 HOURS:6,202 COSTS(000):$0
Public Housing Assessment System (PHAS) Management Operations
Certification
FORMS: HUD-50072
OMB NO: 2535-0107 EXPIRATION DATE: 11/30/2003
RESPS:5,964 HOURS:31,961 COSTS(000):$0
Public Housing Financial Management Template
FORMS: NONE
OMB NO: 2535-0113 EXPIRATION DATE: 08/31/2003
RESPS:1 HOURS:1 COSTS(000):$0
Standardized Form for "Race and Ethnic Data Collection"
FORMS: HUD-27061
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
5 246,346 124,088 $0
Office of Lead-Based Paint and Poison Prevention
OMB NO: 2539-0008 EXPIRATION DATE: 01/31/2004
RESPS:520 HOURS:6,240 COSTS(000):$0
Lead-Based Paint Hazard Control Grant Program Data Collection
FORMS: HUD-96006
OMB NO: 2539-0009 EXPIRATION DATE: 12/31/2005
RESPS:2,355,621 HOURS:253,742 COSTS(000):$3,593
Requirements for Lead-Based Paint Hazards in Federally Owned
Resisential Properties and Housing Receiving Federal Assistance
FORMS: NONE
OMB NO: 2539-0010 EXPIRATION DATE: 06/30/2003
RESPS:50 HOURS:2,136 COSTS(000):$0
Notice of Funding Availability / Improving the Evaluation and
Control of Residential Lead-Based Hazards
FORMS: NONE
OMB NO: 2539-0015 EXPIRATION DATE: 01/31/2004
RESPS:290 HOURS:19,040 COSTS(000):$0
Notice of Funding Availability Lead-Based Hazard Control,
Healthy Homes Demonstration, Operation Lead Elimination Action
Program, and Healthy Homes and Lead Technical Studies Grant
Program
FORMS: HUD-424 HUD-424B HUD-424C HUD-2880 HUD-50070 HUD-50071 SF-LLL
OMB NO: 2539-0017 EXPIRATION DATE: 05/31/2003
RESPS:3 HOURS:425 COSTS(000):$0
A Study of the Effectiveness of the Milwaukee Lead Hazard
Control Ordinance
FORMS: NONE
OMB NO: 2539-0018 EXPIRATION DATE: 06/30/2003
RESPS:365 HOURS:43 COSTS(000):$0
Evaluation of Environmental Interventions Conducted under HUD
Lead-Based Paint Abatement Program
FORMS: NONE
OMB NO: 2539-0019 EXPIRATION DATE: 06/30/2004
RESPS:150 HOURS:700 COSTS(000):$0
First National Survey of Environmental Hazards in Child Care
Centers
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
7 2,356,999 282,326 $3,593
Office of Public and Indian Housing
OMB NO: 2577-0006 EXPIRATION DATE: 03/31/2006
RESPS:3,330 HOURS:158,400 COSTS(000):$0
Public Housing Agency (PHA), Lease Requirements, Recordkeeping
Requirements
FORMS: NONE
OMB NO: 2577-0012 EXPIRATION DATE: 08/31/2004
RESPS:716 HOURS:2,652 COSTS(000):$0
Outline Specifications
FORMS: HUD-5087
OMB NO: 2577-0015 EXPIRATION DATE: 09/30/2005
RESPS:2,630 HOURS:8,548 COSTS(000):$0
Contract for Development of A/E Services.
FORMS: HUD-51915 HUD-51915-A
OMB NO: 2577-0021 EXPIRATION DATE: 06/30/2004
RESPS:147 HOURS:147 COSTS(000):$0
Consolidated Public Housing Certificate of Completion
FORMS: NONE
OMB NO: 2577-0024 EXPIRATION DATE: 11/30/2003
RESPS:238 HOURS:1,428 COSTS(000):$0
Life-Cycle Cost Analysis of Utility Combination in Public Housing
FORMS: HUD-51994
OMB NO: 2577-0025 EXPIRATION DATE: 09/30/2004
RESPS:10,150 HOURS:20,155 COSTS(000):$0
Periodical Estimate for Partial Payment and Related Schedules
FORMS: HUD-51001 HUD-51002 HUD-51003 HUD-51004
OMB NO: 2577-0027 EXPIRATION DATE: 05/31/2003
RESPS:3,792 HOURS:720 COSTS(000):$0
Public Housing Construction Report
FORMS: HUD-5378
OMB NO: 2577-0029 EXPIRATION DATE: 10/31/2004
RESPS:22,400 HOURS:16,038 COSTS(000):$0
Allocation of Operating Subsidies Under the Operating Fund
Formula: Data Collection (formerly the Performance Funding
System (PFS)).
FORMS: HUD-52720-A HUD-52720-B HUD-52720-C HUD-52721 HUD-52722-A
HUD-52722-B HUD-52723 HUD-53087
OMB NO: 2577-0033 EXPIRATION DATE: 06/30/2004
RESPS:334 HOURS:7,595 COSTS(000):$0
Public Housing Development and Mixed-Finance Development of
Units; Proposal, Financial Feasibility, Site Information Turnkey
Method, Evidentiary Materials
FORMS: HUD-51971-I HUD-51971-II HUD-52482 HUD-52483-A HUD-52485
HUD-52651-A
OMB NO: 2577-0036 EXPIRATION DATE: 05/31/2004
RESPS:2,435 HOURS:11,667 COSTS(000):$0
Public Housing Agency (PHA) Development cost Budget/Cost
Statement, Actual Development Cost Certification, Acquisition
and Relocation Report
FORMS: HUD-52427 HUD-52484
OMB NO: 2577-0037 EXPIRATION DATE: 08/31/2004
RESPS:110 HOURS:248 COSTS(000):$0
Analysis of Proposed Main Construction Contract
FORMS: HUD-52396
OMB NO: 2577-0039 EXPIRATION DATE: 03/31/2004
RESPS:11,608 HOURS:14,506 COSTS(000):$0
Contract Administration - Public and Indian Housing
FORMS: HUD-5372 HUD-5100
OMB NO: 2577-0044 EXPIRATION DATE: 04/30/2004
RESPS:1,000 HOURS:10,000 COSTS(000):$0
Comprehensive Improvement Assistance Program (CIAP)
Budget/Progress Report and Actual Modernization Cost Certificate
FORMS: HUD-52825 HUD-53001
OMB NO: 2577-0045 EXPIRATION DATE: 05/31/2004
RESPS:60 HOURS:60 COSTS(000):$0
Insurance Information
FORMS: HUD-5460
OMB NO: 2577-0046 EXPIRATION DATE: 10/31/2004
RESPS:12,000 HOURS:12,000 COSTS(000):$0
Procedure for Obtaining Certificates of Insurance for Capital
Program Projects
FORMS: NONE
OMB NO: 2577-0066 EXPIRATION DATE: 09/30/2004
RESPS:3,100 HOURS:6,200 COSTS(000):$0
Housing Agency (HA) Calculation of Occupancy Percentage for
Requested Budget Year (RBY) PHA-Owned Rental Housing,
Performance Funding System (PFS)
FORMS: HUD-52728
OMB NO: 2577-0075 EXPIRATION DATE: 03/31/2005
RESPS:120 HOURS:2,010 COSTS(000):$0
Demolition/Disposition Application and Reporting
FORMS: HUD-52860
OMB NO: 2577-0078 EXPIRATION DATE: 10/31/2004
RESPS:32,000 HOURS:256 COSTS(000):$0
Pet Ownership in Public Housing for the Elderly or Persons with
Disabilities
FORMS: NONE
OMB NO: 2577-0083 EXPIRATION DATE: 09/30/2003
RESPS:4,689,165 HOURS:1,563,054 COSTS(000):$0
Multifamily Tenant Characteristics Family Reporting
FORMS: HUD-50058 HUD-50058-MTW
OMB NO: 2577-0087 EXPIRATION DATE: 03/31/2004
RESPS:1,916 HOURS:3,832 COSTS(000):$0
Tenant Opportunities Program (TOP) Semi-Annual Report
FORMS: HUD-52370
OMB NO: 2577-0088 EXPIRATION DATE: 06/30/2004
RESPS:3,596 HOURS:3,596 COSTS(000):$0
Contract and Subcontract Activity
FORMS: HUD-2516
OMB NO: 2577-0090 EXPIRATION DATE: 06/30/2004
RESPS:3,100 HOURS:3,100 COSTS(000):$0
Annual Lead-Based Paint Activity Report
FORMS: HUD-52850
OMB NO: 2577-0094 EXPIRATION DATE: 11/30/2003
RESPS:2,694 HOURS:2,694 COSTS(000):$0
General Conditions of the Contract for Construction - Public
Housing Programs
FORMS: HUD-5370
OMB NO: 2577-0133 EXPIRATION DATE: 02/29/2004
RESPS:1,500 HOURS:30,000 COSTS(000):$0
Public and Indian Housing Drug Elimination Technical Assistance
Program (DETAP) Consultant Services - Application Kit
FORMS: HUD-52354
OMB NO: 2577-0161 EXPIRATION DATE: 08/31/2003
RESPS:1 HOURS:8,500 COSTS(000):$0
Public Housing-Contracting with Resident-Owned Businesses
Application Requirements
FORMS: NONE
OMB NO: 2577-0166 EXPIRATION DATE: 02/29/2004
RESPS:116,864 HOURS:17,540 COSTS(000):$0
Public and Indian Housing-LOCCS/VRS Payment Vouchers
FORMS: HUD-50080SERIES
OMB NO: 2577-0169 EXPIRATION DATE: 03/31/2004
RESPS:2,562,500 HOURS:775,750 COSTS(000):$0
Housing Choice Voucher Program (Part 982)
FORMS: HUD-52515 HUD-52517 HUD-52580 HUD-52580-A HUD-52646 HUD-52663
HUD-52665 HUD-52667 HUD-52672 HUD-52673......
OMB NO: 2577-0178 EXPIRATION DATE: 05/31/2003
RESPS:4,550 HOURS:39,090 COSTS(000):$0
Family Self-Sufficiency Program (FSS)
FORMS: HUD-52650 HUD-52552
OMB NO: 2577-0186 EXPIRATION DATE: 04/30/2004
RESPS:19 HOURS:190 COSTS(000):$0
Financial Standards for Housing Agency-Owned Insurance Entities
FORMS: NONE
OMB NO: 2577-0191 EXPIRATION DATE: 05/31/2003
RESPS:1 HOURS:12,800 COSTS(000):$0
Application for Indian Community Development Block Grant (ICDBG)
Program
FORMS: HUD-4121 HUD-4122 HUD-4123 HUD-4125 HUD-4126
OMB NO: 2577-0192 EXPIRATION DATE: 06/30/2004
RESPS:176 HOURS:3,358 COSTS(000):$0
Requirements for Designating Housing Projects Plan
FORMS: NONE
OMB NO: 2577-0200 EXPIRATION DATE: 06/30/2005
RESPS:250 HOURS:46 COSTS(000):$0
Loan Guarantees for Indian Housing
FORMS: HUD-53036 HUD-53038
OMB NO: 2577-0201 EXPIRATION DATE: 01/31/2005
RESPS:73 HOURS:5,421 COSTS(000):$0
Section 5(h) Homeownership Program for Public Housing:
Submission of Plan and Reporting
FORMS: NONE
OMB NO: 2577-0208 EXPIRATION DATE: 12/31/2004
RESPS:80 HOURS:29,773 COSTS(000):$0
HOPE VI Application Requirements (Data Forms, Budget, etc.),
Reporting, Procurement
FORMS: HUD-52600-A HUD-52825-A
OMB NO: 2577-0211 EXPIRATION DATE: 04/30/2004
RESPS:224 HOURS:1,792 COSTS(000):$0
Economic Development and Supportive Services Program: Reporting
Requirements
FORMS: NONE
OMB NO: 2577-0215 EXPIRATION DATE: 08/31/2003
RESPS:2,565 HOURS:34,720 COSTS(000):$0
Section 8 Management Assessment Program (SEMAP)
FORMS: HUD-52648
OMB NO: 2577-0218 EXPIRATION DATE: 11/30/2004
RESPS:1 HOURS:134,592 COSTS(000):$0
Indian Housing Plan (IHP); Annual Performance Report (APR);
FORMS: IHP-52735 APR-52735-AS
OMB NO: 2577-0220 EXPIRATION DATE: 11/30/2004
RESPS:3,200 HOURS:256,000 COSTS(000):$0
Admission to, and Occupancy of Public Housing: Admission and
Tenant Selection Policies, Verification, Notification
Preference, Waiting List, Exemption of Police Officers
FORMS: NONE
OMB NO: 2577-0226 EXPIRATION DATE: 02/28/2006
RESPS:4,100 HOURS:85,800 COSTS(000):$0
Public Housing Agency (PHA) Plan
FORMS: NONE
OMB NO: 2577-0229 EXPIRATION DATE: 11/30/2003
RESPS:850 HOURS:44,800 COSTS(000):$0
Resident Opportunities Self-Sufficiency (ROSS) Program:
Application Requirements, Evaluation, Assessment, Certifications
FORMS: NONE
OMB NO: 2577-0230 EXPIRATION DATE: 04/30/2003
RESPS:3,400 HOURS:169,300 COSTS(000):$0
Public Housing Reform; Change in Admission and Occupancy
Requirements
FORMS: NONE
OMB NO: 2577-0232 EXPIRATION DATE: 03/31/2006
RESPS:4,500 HOURS:10,850 COSTS(000):$0
Screening and Eviction for Drug Abuse and other Criminal
Activity-Final Rule
FORMS: NONE
OMB NO: 2577-0233 EXPIRATION DATE: 06/30/2003
RESPS:1,000 HOURS:9,720 COSTS(000):$0
Public Housing Homeownership Program Family Application,
Reporting and Recordkeeping Requirements, Homeownership Program
Application and Approval
FORMS: NONE
OMB NO: 2577-0237 EXPIRATION DATE: 08/31/2004
RESPS:939 HOURS:34,026 COSTS(000):$0
Public Housing Assessment System (PHAS) Memorandum of Agreement
(MOA) and Improvement Plan (IP)
FORMS: NONE
OMB NO: 2577-0238 EXPIRATION DATE: 12/31/2004
RESPS:365 HOURS:820 COSTS(000):$7,500
Revision to Cost Limits for Native American Housing
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
45 7,513,799 3,553,794 $7,500
AGENCY TOTALS:
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
246 150,147,999 22,228,696 $20,190
Department of the Interior
Bureau of Land Management
OMB NO: 1004-0001 EXPIRATION DATE: 01/31/2004
RESPS:450 HOURS:215 COSTS(000):$0
Free Use Application and Permit - Vegetative or Mineral Material
(as required by 43 CFR 3620, 5510)
FORMS: FORM-5510-1
OMB NO: 1004-0004 EXPIRATION DATE: 08/31/2003
RESPS:17 HOURS:34 COSTS(000):$0
Desert Land entry Application
FORMS: FORM-2520-1
OMB NO: 1004-0005 EXPIRATION DATE: 02/28/2005
RESPS:6,000 HOURS:2,000 COSTS(000):$0
Grazing Application - Grazing Schedules (43 CFR 4130)
FORMS: 4130-1
OMB NO: 1004-0009 EXPIRATION DATE: 10/31/2004
RESPS:641 HOURS:3,140 COSTS(000):$312
Land Use Application and Permit (43 CFR 2920)
FORMS: 2920-1
OMB NO: 1004-0010 EXPIRATION DATE: 08/31/2003
RESPS:20 HOURS:20 COSTS(000):$0
Conveyances Affecting Color or Claim of title
FORMS: FORM-2540-2
OMB NO: 1004-0011 EXPIRATION DATE: 08/31/2003
RESPS:20 HOURS:20 COSTS(000):$0
Color-of-Title Tax Levy and Payment Record
FORMS: FORM-2540-3
OMB NO: 1004-0012 EXPIRATION DATE: 08/31/2003
RESPS:25 HOURS:1,000 COSTS(000):$3
Application for Land for Recreation and Public Purposes
FORMS: FORM-2740-1
OMB NO: 1004-0019 EXPIRATION DATE: 01/31/2004
RESPS:60 HOURS:20 COSTS(000):$0
Range Improvement Permit (43 CFR 4120.3)
FORMS: FORM-4120-7
OMB NO: 1004-0025 EXPIRATION DATE: 07/31/2003
RESPS:255 HOURS:12,185 COSTS(000):$6,612
43 CFR 3860 & 3870 -- Mineral Surveys, Mineral Patent
Applications, Adverse Claims, Protests, & Contests
FORMS: 3860-2 3860-5
OMB NO: 1004-0029 EXPIRATION DATE: 08/31/2003
RESPS:20 HOURS:10 COSTS(000):$0
Color-of-Title Application Form
FORMS: FORM-2540-1
OMB NO: 1004-0034 EXPIRATION DATE: 10/31/2004
RESPS:60,000 HOURS:30,000 COSTS(000):$3,000
Oil and Gas Lease Transfers by Assignment or Operating Rights
(Sublease) (43 CFR 3106, 3135, adn 3216)
FORMS: 3000-1 3000-3A
OMB NO: 1004-0041 EXPIRATION DATE: 02/28/2005
RESPS:7,689 HOURS:1,794 COSTS(000):$0
Automated Grazing Application (formerly Grazing Preference
Statement) (43 CFR 4130)
FORMS: 4130-3A
OMB NO: 1004-0042 EXPIRATION DATE: 06/30/2004
RESPS:30,000 HOURS:5,000 COSTS(000):$0
The Application for Adoption of Wild Horses(s) and Burro(s) (43
CFR 4700)
FORMS: 4710-10
OMB NO: 1004-0051 EXPIRATION DATE: 06/30/2004
RESPS:15,000 HOURS:6,250 COSTS(000):$0
Actual Grazing Use Report (43 CFR 4130)
FORMS: 4130-5
OMB NO: 1004-0058 EXPIRATION DATE: 01/31/2004
RESPS:25 HOURS:45 COSTS(000):$0
Timber Export Reporting and Substitution Determination (43 CFR
Subpart 5424)
FORMS: FORM-5460-17
OMB NO: 1004-0068 EXPIRATION DATE: 05/31/2005
RESPS:600 HOURS:200 COSTS(000):$0
Cooperative Range Improvement Agreement (43 CFR 4120.3-2)
FORMS: 4120-6
OMB NO: 1004-0073 EXPIRATION DATE: 12/31/2003
RESPS:1,185 HOURS:23,986 COSTS(000):$40
43 C.F.R. Group 3400, Coal Management
FORMS: 3400-12 3440-1
OMB NO: 1004-0074 EXPIRATION DATE: 07/31/2003
RESPS:443 HOURS:886 COSTS(000):$0
Oil and Gas and Geothemal Resources Leasing
FORMS: 3000-2 3200-9
OMB NO: 1004-0103 EXPIRATION DATE: 02/28/2005
RESPS:4,400 HOURS:2,200 COSTS(000):$0
Mineral Materials Disposal (43 CFR 3600, 3601, and 3602)
FORMS: 3600-9
OMB NO: 1004-0109 EXPIRATION DATE: 06/30/2003
RESPS:50 HOURS:1,000 COSTS(000):$0
Payments in Lieu of Taxes (43 CFR 1881)
FORMS: 1004-0109
OMB NO: 1004-0114 EXPIRATION DATE: 11/30/2003
RESPS:236,852 HOURS:31,585 COSTS(000):$368
Recordation of Location Notices and Annual for Mining Claims,
Mill Sites, and Tunnel Sites; Payment of Location and Maintenace
Fees and Service Charges (43 CFR 3730, 3810, 3830, and 3850
FORMS: 3830-2 3830-3
OMB NO: 1004-0119 EXPIRATION DATE: 05/31/2004
RESPS:31,000 HOURS:15,500 COSTS(000):$0
Special Recreation Application and Permit (43 CFR 8370)
FORMS: 8370-1
OMB NO: 1004-0121 EXPIRATION DATE: 06/30/2003
RESPS:276 HOURS:3,760 COSTS(000):$3
Leasing of Solid Minerals Other Than Coal and Oil Shale: 43 CFR
Part 3500 through 3590
FORMS: 3510-1 3520-7 3510-2 3504-1 3504-3 3504-4
OMB NO: 1004-0132 EXPIRATION DATE: 01/31/2004
RESPS:760 HOURS:1,700 COSTS(000):$0
Geothermal Resources Operations (as required by 43 CFR 3260)
FORMS: 3260-2 3260-3 3260-4 3260-5
OMB NO: 1004-0133 EXPIRATION DATE: 05/31/2004
RESPS:353,000 HOURS:11,767 COSTS(000):$0
Permit Fee Envelope (36 CFR 71)
FORMS: FORM-1370-36
OMB NO: 1004-0134 EXPIRATION DATE: 01/31/2004
RESPS:193,855 HOURS:96,885 COSTS(000):$0
Onshore Oil and Gas Operations Nonform Items (as required by 43
CFR 3160)
FORMS: NONE
OMB NO: 1004-0135 EXPIRATION DATE: 01/31/2004
RESPS:34,000 HOURS:14,166 COSTS(000):$0
Sundry Notices and Reports on Wells (as required by 43 CFR 3162)
FORMS: 3160-5
OMB NO: 1004-0136 EXPIRATION DATE: 01/31/2004
RESPS:4,000 HOURS:2,250 COSTS(000):$0
Application for Permit to Drill (as required by 43 CFR 3162)
FORMS: 3160-3
OMB NO: 1004-0137 EXPIRATION DATE: 01/31/2004
RESPS:2,200 HOURS:2,290 COSTS(000):$0
Well Completion or Recompletion Report and Log (as required by
43 CFR Part 3160)
FORMS: 3160-4
OMB NO: 1004-0145 EXPIRATION DATE: 11/30/2005
RESPS:1,770 HOURS:2,235 COSTS(000):$0
Oil and Gas Exploration and Leasing (43 CFR 3100, 3120, and 3150
FORMS: 3100-11
OMB NO: 1004-0153 EXPIRATION DATE: 11/30/2005
RESPS:30 HOURS:300 COSTS(000):$2
43 CFR Part 2720, Conveyance of Federally-Owned Mineral Interests
FORMS: NONE
OMB NO: 1004-0157 EXPIRATION DATE: 12/31/2003
RESPS:80 HOURS:240 COSTS(000):$0
43 CFR Subpart 2808 - Reimbursement of Costs
FORMS: NONE
OMB NO: 1004-0160 EXPIRATION DATE: 10/31/2004
RESPS:75 HOURS:150 COSTS(000):$0
Geothermal Leasing Reports (43 CFR 3208)
FORMS: NONE
OMB NO: 1004-0162 EXPIRATION DATE: 12/31/2005
RESPS:1,253 HOURS:836 COSTS(000):$0
Oil and Gas Geophysical Exploration Operations (43 CFR 3150)
FORMS: 3150-4 3150-5 2800-16 2800-16A
OMB NO: 1004-0165 EXPIRATION DATE: 08/31/2003
RESPS:60 HOURS:155 COSTS(000):$0
Cave Management: Cave Nominations and Confidential Information
43 CFR Part 37
FORMS: NONE
OMB NO: 1004-0168 EXPIRATION DATE: 06/30/2004
RESPS:1,600 HOURS:1,600 COSTS(000):$0
Report on Road Use (43 CFR 2812)
FORMS: OR-2812-6
OMB NO: 1004-0169 EXPIRATION DATE: 06/30/2005
RESPS:150 HOURS:300 COSTS(000):$0
Use and Occupancy (43 CFR 3715)
FORMS: NONE
OMB NO: 1004-0172 EXPIRATION DATE: 12/31/2004
RESPS:10,000 HOURS:500 COSTS(000):$0
Generic Clearance for Customer Comment Cards
FORMS: NONE
OMB NO: 1004-0179 EXPIRATION DATE: 06/30/2004
RESPS:304 HOURS:912 COSTS(000):$0
In-Kind Crude Helium Sales Contract (43 CFR 3195)
FORMS: NONE
OMB NO: 1004-0180 EXPIRATION DATE: 08/31/2004
RESPS:200 HOURS:50 COSTS(000):$0
Gas Well Data Survey of Helium-Bearing Natural Gas (PL 104-273)
FORMS: 3100-12
OMB NO: 1004-0181 EXPIRATION DATE: 12/31/2004
RESPS:13,000 HOURS:3,250 COSTS(000):$0
Generic Clearance for Customer Surveys
FORMS: NONE
OMB NO: 1004-0182 EXPIRATION DATE: 09/30/2004
RESPS:6 HOURS:7 COSTS(000):$0
Alaska Reindeer Grazing (43 CFR 4300)
FORMS: AK-4201-1 AK-4132-2
OMB NO: 1004-0184 EXPIRATION DATE: 04/30/2005
RESPS:22,945 HOURS:9,441 COSTS(000):$0
Onshore Oil and Gas Leasing and Operations (43 CFR Part 3100 et
al.)
FORMS: NONE
OMB NO: 1004-0185 EXPIRATION DATE: 06/30/2005
RESPS:1,110 HOURS:4,600 COSTS(000):$0
Drainage Protection (43 CFR Subparts 3100 and 3162)
FORMS: NONE
OMB NO: 1004-0187 EXPIRATION DATE: 12/31/2005
RESPS:5,000 HOURS:83 COSTS(000):$0
Social Security Number/Taxpayer Identification Number (SSN/TIN)
Request
FORMS: 1372-6
OMB NO: 1004-0188 EXPIRATION DATE: 11/30/2003
RESPS:5,066 HOURS:126,650 COSTS(000):$1,862
Rights-of-Way, Federal Land Policy and Management Act of 1976,
and Rights-of-Way, Mineral Leasing Act of 1920 (43 CFR 2800 and
2880).
FORMS: NONE
OMB NO: 1004-0189 EXPIRATION DATE: 10/31/2005
RESPS:5,066 HOURS:126,650 COSTS(000):$1,862
Application for Transportation and Utility Systems and
Facilities on Federal Lands, Standard Form 299.
FORMS: NONE
OMB NO: 1004-0190 EXPIRATION DATE: 10/31/2005
RESPS:6 HOURS:12 COSTS(000):$1
Indian Allotments
FORMS: 2530-1
OMB NO: 1004-0192 EXPIRATION DATE: 06/30/2003
RESPS:1,760 HOURS:440 COSTS(000):$0
Trans-Alaska Pipeline System Survey of the Employee Concerns
Program
FORMS: NONE
OMB NO: 1004-0193 EXPIRATION DATE: 08/31/2003
RESPS:1,720 HOURS:430 COSTS(000):$0
Generic Clearance for Customer Surveys for Stakeholders/Partners
and State and Local Government
FORMS: NONE
OMB NO: 1004-0194 EXPIRATION DATE: 11/30/2003
RESPS:1,897 HOURS:306,536 COSTS(000):$0
Surface Management Activities Under the General Mining Law, 43
CFR Subpart 3809
FORMS: 3809-1 3809-2 3809-4
OMB NO: 1004-0195 EXPIRATION DATE: 02/29/2004
RESPS:540 HOURS:240 COSTS(000):$0
Program Evaluation for the National Riparian Management Service
Team (NRST) and the extended riparian network
FORMS: NONE
OMB NO: 1004-0196 EXPIRATION DATE: 12/31/2004
RESPS:35 HOURS:410 COSTS(000):$0
Oil and Gas Leasing: National Petroleum Reserve, Alaska (NPRA)
(43 CFR 3130, 3133, 3135, 3137, 3138, 3160)
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
53 1,056,516 855,935 $14,065
Bureau of Reclamation
OMB NO: 1006-0001 EXPIRATION DATE: 02/28/2006
RESPS:25,225 HOURS:8,050 COSTS(000):$0
Crop Acreage and Yields and Water Distribution
FORMS: 7-332 7-2045
OMB NO: 1006-0002 EXPIRATION DATE: 04/30/2003
RESPS:535 HOURS:1,070 COSTS(000):$0
Recreation Use Data Report
FORMS: 7-2534-PART1 7-2535-PART2
OMB NO: 1006-0003 EXPIRATION DATE: 01/31/2006
RESPS:500 HOURS:1,000 COSTS(000):$100
Right-of-Use Application, 43 CFR 429
FORMS: 7-2540
OMB NO: 1006-0005 EXPIRATION DATE: 12/31/2003
RESPS:19,586 HOURS:14,829 COSTS(000):$0
Individual Landholder's Certification and Reporting Forms for
Acreage Limitation, 43 CFR Part 426 and 43 CFR Part 428
FORMS: 7-21INFO 7-2180 7-2180EZ 7-2181 7-2184 7-2190 7-2190EZ 7-2191
7-2194 7-21PE
OMB NO: 1006-0006 EXPIRATION DATE: 12/31/2003
RESPS:345 HOURS:13,800 COSTS(000):$235
Certification Summary Form, Reporting Summary Form for Acreage
Limitation, 43 CFR Part 426 and 43 CFR Part 428
FORMS: 7-21SUMM-C 7-21SUMM-R
OMB NO: 1006-0014 EXPIRATION DATE: 01/31/2006
RESPS:1,000 HOURS:500 COSTS(000):$0
Lower Colorado River Well Inventory
FORMS: NONE
OMB NO: 1006-0015 EXPIRATION DATE: 08/31/2003
RESPS:54 HOURS:290 COSTS(000):$0
Diversions, Return Flows, and Consumptive Use of Colorado River
Water in the Lower Colorado River Basin
FORMS: LC-72 LC-72A LC-72B
OMB NO: 1006-0023 EXPIRATION DATE: 12/31/2003
RESPS:1,105 HOURS:92 COSTS(000):$0
Limited Recipient Identification Sheet and Trust Information
Sheet for Acreage Limitation, 43 CFR Part 426
FORMS: 7-2536 7-2537
OMB NO: 1006-0024 EXPIRATION DATE: 12/31/2005
RESPS:44 HOURS:44 COSTS(000):$0
Summary of Water Requirements for Crops Grown on Eligible Land
FORMS: LS-924
OMB NO: 1006-0025 EXPIRATION DATE: 09/30/2003
RESPS:250 HOURS:125 COSTS(000):$0
Ririe Reservoir Recreation Survey
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
10 48,644 39,800 $335
Minerals Management Service
OMB NO: 1010-0006 EXPIRATION DATE: 03/31/2004
RESPS:8,815 HOURS:16,329 COSTS(000):$414
30 CFR Part 256, Leasing of Sulphur or Oil and Gas in the Outer
Continental Shelf (OCS)
FORMS: FORM-MMS-2028 FORM-MMS-2028A
OMB NO: 1010-0017 EXPIRATION DATE: 08/31/2005
RESPS:13,600 HOURS:1,336 COSTS(000):$0
Form MMS-128, Semiannual Well Test Report (SWTR)
FORMS: MMS-128
OMB NO: 1010-0018 EXPIRATION DATE: 08/31/2004
RESPS:960 HOURS:960 COSTS(000):$0
Form MMS-127, Sensitive Reservior Informaiton Report (SRI)
FORMS: MMS-127
OMB NO: 1010-0039 EXPIRATION DATE: 08/31/2004
RESPS:1,250 HOURS:1,250 COSTS(000):$0
Form MMS-126, Well Potential Test Report (WPT)
FORMS: MMS-126
OMB NO: 1010-0041 EXPIRATION DATE: 06/30/2003
RESPS:1,949 HOURS:14,189 COSTS(000):$0
30 CFR 250, Subpart K, Oil and Gas Production Rates
FORMS: MMS-140
OMB NO: 1010-0042 EXPIRATION DATE: 04/30/2004
RESPS:17 HOURS:19 COSTS(000):$0
Sale of Federal Royalty Oil, 30 CFR Part 208 (Originally titled
"Application for the Purchase of Royalty Oil"
FORMS: MMS-4070
OMB NO: 1010-0043 EXPIRATION DATE: 08/31/2004
RESPS:11,625 HOURS:19,205 COSTS(000):$0
30 CFR 250, Subpart F, Oil and Gas Well-Workover Operations
FORMS: NONE
OMB NO: 1010-0044 EXPIRATION DATE: 10/31/2005
RESPS:1,315 HOURS:3,288 COSTS(000):$0
Form MMS-123, Application for Permit to Drill (APD)
FORMS: MMS-123
OMB NO: 1010-0045 EXPIRATION DATE: 10/31/2005
RESPS:13,570 HOURS:16,963 COSTS(000):$0
Please note NEW title for this form: Form MMS-124, Application
for Permit to Modify
FORMS: MMS-124
OMB NO: 1010-0046 EXPIRATION DATE: 10/31/2005
RESPS:3,230 HOURS:3,230 COSTS(000):$0
Please note NEW Title for this form: Form MMS-125, End of
Operations Report
FORMS: MMS-125
OMB NO: 1010-0048 EXPIRATION DATE: 05/31/2003
RESPS:963 HOURS:8,109 COSTS(000):$0
30 CFR Part 251, Geological and Geophysical (G&G) Explorations
of the OCS
FORMS: MMS-327 MMS-328 MMS-329
OMB NO: 1010-0049 EXPIRATION DATE: 09/30/2003
RESPS:1,016 HOURS:257,470 COSTS(000):$0
30 CFR 250, Subpart B, Exploration and Development and Production
FORMS: MMS-137 MMS-138 MMS-139 MMS-141
OMB NO: 1010-0050 EXPIRATION DATE: 01/31/2006
RESPS:2,972 HOURS:106,086 COSTS(000):$370
30 CFR 250, Subpart J, Pipelines and Pipeline Rights-of-Way
FORMS: 2030
OMB NO: 1010-0051 EXPIRATION DATE: 07/31/2004
RESPS:36,098 HOURS:6,540 COSTS(000):$0
30 CFR 250, Subpart L, Oil and Gas Production Measurement,
Surface Commingling, and Security
FORMS: NONE
OMB NO: 1010-0057 EXPIRATION DATE: 01/31/2006
RESPS:5,462 HOURS:159,913 COSTS(000):$0
30 CFR 250, Subpart C, Pollution Prevention and Control
FORMS: NONE
OMB NO: 1010-0058 EXPIRATION DATE: 09/30/2004
RESPS:787 HOURS:28,344 COSTS(000):$0
30, CFR 250, Subpart I, Platforms and Structures
FORMS: NONE
OMB NO: 1010-0059 EXPIRATION DATE: 01/31/2006
RESPS:2,133 HOURS:11,357 COSTS(000):$0
30 CFR 250, Subpart H, Oil and Gas Production Safety Systems
FORMS: NONE
OMB NO: 1010-0061 EXPIRATION DATE: 10/31/2004
RESPS:20 HOURS:5 COSTS(000):$0
Oil Transportation Allowances (30 CFR Part 206.55(a)(1)(i); (b)
(1); (c)(1)(i) and (iii), and (iv))
FORMS: MMS-4110
OMB NO: 1010-0067 EXPIRATION DATE: 08/31/2004
RESPS:2,285 HOURS:9,520 COSTS(000):$0
30 CFR 250, Subpart E, Oil and Gas Well-Completion Operations
FORMS: NONE
OMB NO: 1010-0068 EXPIRATION DATE: 08/31/2005
RESPS:460 HOURS:5,396 COSTS(000):$0
30 CFR 250, Subpart M, Unitization
FORMS: NONE
OMB NO: 1010-0071 EXPIRATION DATE: 09/30/2003
RESPS:22 HOURS:8,650 COSTS(000):$661
30 CFR Part 203, Relief or Reduction in Royalty Rates
FORMS: NONE
OMB NO: 1010-0072 EXPIRATION DATE: 01/31/2006
RESPS:21 HOURS:108 COSTS(000):$0
30 CFR Part 280, Prospecting for Minerals other than Oil, Gas,
and Sulphur on the OCS
FORMS: 134 135 136
OMB NO: 1010-0073 EXPIRATION DATE: 08/31/2005
RESPS:319 HOURS:3,674 COSTS(000):$0
30 CFR Part 220, Accounting Procedures for Determining Net
Profit Share Payment for Outer Continental Shelf Oil and Gas
Leases (30 CFR 220.010(a); 220.030(a); 220.031(a), (b), (d), (e);
FORMS: NONE
OMB NO: 1010-0074 EXPIRATION DATE: 10/31/2004
RESPS:2 HOURS:4 COSTS(000):$0
Coal Washing and transportation Allowances (30 CFR
206.458(a)(1), (b)(1), (c)(1)(i)&(iii), (c)(2)(i)&(iii) and
206.461(a)(1), (b)(1), (c)(1)(i)&(iii), (c)(2)(i)&(iii))
FORMS: MMS-4292 MMS-4293
OMB NO: 1010-0075 EXPIRATION DATE: 10/31/2004
RESPS:3,000 HOURS:750 COSTS(000):$0
Gas Processing and Transportation Allowances (30 CFR Part
206.178 (b)(1)(ii) and 206.180(b)(1)(ii))
FORMS: MMS-4109 MMS-4295
OMB NO: 1010-0086 EXPIRATION DATE: 08/31/2004
RESPS:29 HOURS:903 COSTS(000):$0
30 CFR 250, Subpart P, Sulphur Operations
FORMS: NONE
OMB NO: 1010-0087 EXPIRATION DATE: 08/31/2003
RESPS:85 HOURS:1,224 COSTS(000):$0
Cooperative Agreements
FORMS: NONE
OMB NO: 1010-0088 EXPIRATION DATE: 08/31/2003
RESPS:48,050 HOURS:210,400 COSTS(000):$80
Delegation of Authority to States
FORMS: NONE
OMB NO: 1010-0090 EXPIRATION DATE: 09/30/2004
RESPS:1,600 HOURS:800 COSTS(000):$0
Stripper Royalty Rate Reduction Notification (43 CFR Part
3103.4- 2)
FORMS: MMS-4377
OMB NO: 1010-0091 EXPIRATION DATE: 10/31/2003
RESPS:801 HOURS:42,233 COSTS(000):$0
30 CFR part 254, Oil-Spill Responses Requirements for Facilities
Located Seaward of the Coast Line
FORMS: NONE
OMB NO: 1010-0095 EXPIRATION DATE: 03/31/2005
RESPS:75 HOURS:37 COSTS(000):$0
Request to Exceed Regulatory Allowance Limitation (30 CFR
206.54(b)(2), 206.109(c)(2), 206.156(c)(3), 206.158(c)(3) and
206.177(c)(3))
FORMS: MMS-4393
OMB NO: 1010-0098 EXPIRATION DATE: 03/31/2004
RESPS:200 HOURS:7 COSTS(000):$0
Office of Indian Royalty Assistance (OIRA) Customer Satisfaction
Postcard
FORMS: NONE
OMB NO: 1010-0103 EXPIRATION DATE: 04/30/2003
RESPS:420 HOURS:10,500 COSTS(000):$0
Safety Net Report
FORMS: MMS-4411
OMB NO: 1010-0104 EXPIRATION DATE: 01/31/2005
RESPS:475 HOURS:1,000 COSTS(000):$0
Accounting for Comparison (Dual Accounting) (30 CFR
206.172(b)(1)(iii), 206.173(a)(1) and (2), 206.176(b) and (c))
FORMS: MMS-4410
OMB NO: 1010-0106 EXPIRATION DATE: 09/30/2004
RESPS:1,834 HOURS:19,504 COSTS(000):$0
30 CFR Part 253, Oil Spill Financial Responsibility for Offshore
Facilities
FORMS: MMS-1016 MMS-1017 MMS-1018 MMS-1019 MMS-1020 MMS-1021 MMS-1022
OMB NO: 1010-0107 EXPIRATION DATE: 06/30/2005
RESPS:1,607 HOURS:1,207 COSTS(000):$0
30 CFR Part 218, Subpart B-Oil and Gas, General (formerly
Designation of Royalty Payment Responsibility)
FORMS: MMS-4425 MMS-4280
OMB NO: 1010-0110 EXPIRATION DATE: 08/31/2004
RESPS:1,260 HOURS:126 COSTS(000):$0
Training and Outreach Evaluation Forms
FORMS: MMS-4420A-H
OMB NO: 1010-0112 EXPIRATION DATE: 12/31/2004
RESPS:63 HOURS:756 COSTS(000):$0
Form MMS-131, Performance Data Form
FORMS: MMS-131
OMB NO: 1010-0113 EXPIRATION DATE: 04/30/2003
RESPS:6,075 HOURS:1 COSTS(000):$0
Indian Crude Oil Valuation Report
FORMS: MMS-4416
OMB NO: 1010-0114 EXPIRATION DATE: 07/31/2005
RESPS:18,387 HOURS:22,467 COSTS(000):$2
30 CFR 250, Subpart A, General
FORMS: MMS-132 MMS-1123 MMS-1832
OMB NO: 1010-0119 EXPIRATION DATE: 01/31/2006
RESPS:25 HOURS:100 COSTS(000):$0
Royalty Oil Sales to Eligible Refiners (30 CFR 208.4(a) and (d))
FORMS: NONE
OMB NO: 1010-0120 EXPIRATION DATE: 08/31/2004
RESPS:5,495 HOURS:1,452 COSTS(000):$0
Solid Minerals Compliance and Asset Management Process, 30 CFR
Parts 206, 210, 216, and 218 (Current title: Solid Minerals
Operational Model)
FORMS: MMS-4430
OMB NO: 1010-0121 EXPIRATION DATE: 09/30/2005
RESPS:180 HOURS:265 COSTS(000):$2
Administrative Appeal Procedures (30 CFR 250.1409(a) and (b)(2);
290.4(a) and (b)(1); 290.105(a); and 290.106(a))
FORMS: NONE
OMB NO: 1010-0122 EXPIRATION DATE: 06/30/2005
RESPS:300 HOURS:300 COSTS(000):$1
30 CFR Part 243 Suspensions Pending Appeal and Bonding (formerly
Filing Sureties)
FORMS: MMS-4435 MMS-4436
OMB NO: 1010-0123 EXPIRATION DATE: 08/31/2005
RESPS:12 HOURS:180 COSTS(000):$0
30 CFR Part 242, Subpart C-Requests from Indian Lessors for MMS
to Issue Orders (Requirements contained in proposed rule RIN
1010-AC80)
FORMS: NONE
OMB NO: 1010-0126 EXPIRATION DATE: 05/31/2003
RESPS:4,320 HOURS:3,720 COSTS(000):$0
Royalty-In-Kind Pilot Program Directed Third-Party
Communications Between Operators and Purchasers of RIK Federal
Oil and Gas Purchase System
FORMS: NONE
OMB NO: 1010-0128 EXPIRATION DATE: 08/31/2003
RESPS:717 HOURS:5,739 COSTS(000):$0
30 CFR 250, Subpart O-Well Control & Production Safety Training
FORMS: NONE
OMB NO: 1010-0129 EXPIRATION DATE: 06/30/2003
RESPS:1,869 HOURS:1,324 COSTS(000):$0
Bids and Financial Statements for Sale of Royalty Oil and Gas
(RIK Pilots)
FORMS: FORM-MMS-4440
OMB NO: 1010-0130 EXPIRATION DATE: 04/30/2003
RESPS:30 HOURS:201 COSTS(000):$0
Directed Communications Between Operators of Federaal RIK Leases
and Deliverers of Equivalent Oil Production to the Strategic
Petroleum Reserve
FORMS: NONE
OMB NO: 1010-0131 EXPIRATION DATE: 10/31/2005
RESPS:1,315 HOURS:1,973 COSTS(000):$0
Form MMS-123S, Supplemental APD Information Sheet
FORMS: MMS-123S
OMB NO: 1010-0132 EXPIRATION DATE: 10/31/2005
RESPS:10,000 HOURS:10,000 COSTS(000):$0
Please note NEW title form: Form MMS-133, Well Activity Report
FORMS: MMS-133
OMB NO: 1010-0135 EXPIRATION DATE: 05/31/2003
RESPS:25 HOURS:25 COSTS(000):$0
Royalty-in-King (RIK) Small Refiner Sale Program
FORMS: MMS-4071 MMS-4072
OMB NO: 1010-0136 EXPIRATION DATE: 04/30/2003
RESPS:85 HOURS:17,711 COSTS(000):$0
Federal Oil Valuation
FORMS: NONE
OMB NO: 1010-0137 EXPIRATION DATE: 08/31/2003
RESPS:130 HOURS:90,000 COSTS(000):$0
Historical Well Data Cleanup (HWDC) Project
FORMS: NONE
OMB NO: 1010-0138 EXPIRATION DATE: 04/30/2003
RESPS:2,714 HOURS:1 COSTS(000):$0
Indian Crude Oil Valuation Report
FORMS: NONE
OMB NO: 1010-0139 EXPIRATION DATE: 07/31/2003
RESPS:360,400 HOURS:89,129 COSTS(000):$1,533
Production Accounting and Auditing System Oil and Gas Reports
FORMS: MMS-4054 MMS-4055 MMS-4056 MMS-4058
OMB NO: 1010-0140 EXPIRATION DATE: 08/31/2003
RESPS:2,496,000 HOURS:133,120 COSTS(000):$4,700
Report of Sales and Royalty Remittance
FORMS: MMS-2014
OMB NO: 1010-0141 EXPIRATION DATE: 01/31/2006
RESPS:12,720 HOURS:111,209 COSTS(000):$0
Note New title for this collection: 30 CFR 250, Subpart D, Oil
and Gas Drilling Operations
FORMS: NONE
OMB NO: 1010-0142 EXPIRATION DATE: 07/31/2004
RESPS:1,334 HOURS:6,071 COSTS(000):$0
30 CFR 250, Subpart Q - Decommissioning Activities
FORMS: NONE
OMB NO: 1010-0143 EXPIRATION DATE: 11/30/2003
RESPS:7 HOURS:1,603 COSTS(000):$0
30 CFR Part 260, Outer Continental Shelf Oil and Gas Leasing
FORMS: NONE
OMB NO: 1010-0145 EXPIRATION DATE: 02/29/2004
RESPS:6,338 HOURS:10,792 COSTS(000):$0
Survey-Gulf of Mexico Labor Needs
FORMS: NONE
OMB NO: 1010-0146 EXPIRATION DATE: 09/30/2004
RESPS:130 HOURS:260 COSTS(000):$0
Proposed Rulemaking-30 CFR 250, Subpart A, Crane Requirements
FORMS: NONE
OMB NO: 1010-0147 EXPIRATION DATE: 10/31/2004
RESPS:200 HOURS:800 COSTS(000):$0
Proposed Rulemaking - 30 CFR 250, Subpart J - Safety Measure and
Procedures for Pipeline Modifications and Repairs
FORMS: NONE
OMB NO: 1010-0148 EXPIRATION DATE: 12/31/2004
RESPS:650 HOURS:1,300 COSTS(000):$0
Proposed Rulemaking - 30, CFR 250, Subpart E-Procedures for
Dealing with Sustained Casing Pressure
FORMS: NONE
OMB NO: 1010-0149 EXPIRATION DATE: 02/28/2005
RESPS:806 HOURS:1 COSTS(000):$0
Proposed Rulemaking-30, CFR 250, Subparts J, H, and I, Fixed and
Floating Platforms and Structures
FORMS: NONE
OMB NO: 1010-0150 EXPIRATION DATE: 05/31/2005
RESPS:1,800 HOURS:180 COSTS(000):$0
Form MMS-144-RIG Movement Notification Report
FORMS: MMS-144
OMB NO: 1010-0151 EXPIRATION DATE: 06/30/2005
RESPS:1,182 HOURS:1 COSTS(000):$0
Proposed Rulemaking-30, CFR 250, Subpart B, Plans and Information
FORMS: MMS-137 MMS-138 MMS-139 MMS-141
OMB NO: 1010-0152 EXPIRATION DATE: 06/30/2003
RESPS:380 HOURS:36,960 COSTS(000):$0
Notice toLessees and Operators: Damage Caused by Hurricane Lili
FORMS: NONE
OMB NO: 1010-0154 EXPIRATION DATE: 09/30/2003
RESPS:420 HOURS:310 COSTS(000):$0
Notices to Lesses and Operators Numbers 2002-G07, 2003-G06,and
20 03-G07
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
69 3,102,436 1,518,587 $7,763
United States Fish and Wildlife Service
OMB NO: 1018-0007 EXPIRATION DATE: 09/30/2003
RESPS:56 HOURS:56 COSTS(000):$0
State cert. of hunting and fishing licenses issued annually; 50
CFR 80
FORMS: FORM-3-154A FORM-3-154B
OMB NO: 1018-0010 EXPIRATION DATE: 10/31/2005
RESPS:1,062 HOURS:2,698 COSTS(000):$0
Mourning Dove Call Count Survey
FORMS: 3-159
OMB NO: 1018-0012 EXPIRATION DATE: 10/31/2003
RESPS:85,000 HOURS:21,250 COSTS(000):$0
Declaration for Import or Export of Fish/Wildlife, 50 CFR 14.61-
14.64
FORMS: 3-177
OMB NO: 1018-0014 EXPIRATION DATE: 08/31/2003
RESPS:212 HOURS:1,820 COSTS(000):$0
Special Use Permit Applications on National Wildlife Refuges in
Alaska covers 50 CFR 25.61, 26.22(b), 26.25, 36.33, 36.37, and
36.41.
FORMS: 3-2001
OMB NO: 1018-0015 EXPIRATION DATE: 10/31/2004
RESPS:3,852,000 HOURS:138,917 COSTS(000):$0
Migratory Bird Harvest Surveys
FORMS: 3-1823A 3-2056G 3-2056J 3-2056K 3-2056M 3-165 3-165A 3-165B
3-165C
OMB NO: 1018-0019 EXPIRATION DATE: 10/31/2005
RESPS:750 HOURS:527 COSTS(000):$0
North American Woodcock Singing Ground Survey
FORMS: 3-156
OMB NO: 1018-0022 EXPIRATION DATE: 04/30/2004
RESPS:47,326 HOURS:22,234 COSTS(000):$246
Federal Fish and Wildlife License/Permit Application and Report
FORMS: 3-200-6THRU18 3-200-67THRU70 3-202-1THRU9 3-186 3-186A
OMB NO: 1018-0023 EXPIRATION DATE: 07/31/2003
RESPS:7,400 HOURS:614 COSTS(000):$0
Sandhill Crane Harvest Survey
FORMS: 3-530 3-530A 3-2056N
OMB NO: 1018-0049 EXPIRATION DATE: 09/30/2003
RESPS:1,456 HOURS:5,250 COSTS(000):$0
Grant agreement and amendment to grant agreement
FORMS: FORM-3-1552 FORM-3-1591
OMB NO: 1018-0066 EXPIRATION DATE: 10/31/2004
RESPS:2,695 HOURS:674 COSTS(000):$0
Marine Mammal Marking, Tagging, and Reporting Certificates-50
CFR 18.23(f)
FORMS: R7-50 R7-51 R7-52
OMB NO: 1018-0067 EXPIRATION DATE: 10/31/2003
RESPS:1 HOURS:3,200 COSTS(000):$0
Protocol for Nontoxic Approval Procedures for Shot and Shot
Coatings Migratory Bird Treaty Act
FORMS: NONE
OMB NO: 1018-0070 EXPIRATION DATE: 09/30/2004
RESPS:49 HOURS:1,047 COSTS(000):$0
Incidental Take of Marine Mammals During Specified Activities
Applications; 50 CFR Part 18, Subpart J
FORMS: NONE
OMB NO: 1018-0075 EXPIRATION DATE: 07/31/2003
RESPS:6,900 HOURS:1,725 COSTS(000):$0
Fed. Subsistence Hunt Application, Designated Hunter, Fish/
Shellfish; 50 CFR 100
FORMS: 7-FS-1 7FS-2 7FS-3
OMB NO: 1018-0088 EXPIRATION DATE: 09/30/2003
RESPS:161,000 HOURS:27,000 COSTS(000):$0
FHWAR SURVEY. 16 U.S.C. 669-699i, 742d-f, 777-777k P.L. 98-369
FORMS: FH-2 FH-3 FH-4
OMB NO: 1018-0092 EXPIRATION DATE: 07/31/2004
RESPS:8,236 HOURS:8,233 COSTS(000):$308
Federal Fish and Wildlife License/Permit Application, Law
Enforcement--50 CFR Parts 13, 14, 15, 16, 17, 18, 23
FORMS: 3-200-1 3-200-2 3-200-3 3-200-26
OMB NO: 1018-0093 EXPIRATION DATE: 03/31/2004
RESPS:5,959 HOURS:4,500 COSTS(000):$149
Federal Fish and Wildlife License/Permit Application-Management
Authority; 50 CFR 13, 15, 17, 18, 21, 23
FORMS: 3-200-19/20/21 22/23/24/25 3-200-27/28/29 30/31/32/33/34
35/36/37/38/39 40/41/42/43/44 45/46/47/48/49 50
OMB NO: 1018-0094 EXPIRATION DATE: 07/31/2004
RESPS:1,275 HOURS:4,125 COSTS(000):$17
Federal Fish and Wildlife License Permit Application
Forms-Native Endangered and Threatened Species. 50 CFR 13, 50
CFR 17.22 50 CFR 17.32, 50 CFR 17.62, 50 CFR 17.72
FORMS: 3-200-54 3-200-55 3-200-56
OMB NO: 1018-0095 EXPIRATION DATE: 10/31/2004
RESPS:62 HOURS:16 COSTS(000):$0
Endangered and Threatened Wildlife, 50 CFR 17.84, Experimental
populations.
FORMS: NONE
OMB NO: 1018-0097 EXPIRATION DATE: 01/31/2004
RESPS:2,450 HOURS:875 COSTS(000):$0
Depredation Order for Double-crested Cormorant 50 CFR 21.47
FORMS: NONE
OMB NO: 1018-0100 EXPIRATION DATE: 08/31/2005
RESPS:150 HOURS:37,600 COSTS(000):$0
Information Collection In Support of Grant Programs Authorized
by the North American Wetlands Conservation Act (NAWCA)
FORMS: NONE
OMB NO: 1018-0101 EXPIRATION DATE: 03/31/2005
RESPS:135 HOURS:270 COSTS(000):$0
Monitoring Recovered Species After Delisting As Required Under
Section 4(g) of the Endangered Species Act
FORMS: N/A
OMB NO: 1018-0102 EXPIRATION DATE: 11/30/2004
RESPS:10,440 HOURS:10,440 COSTS(000):$0
Special use permit application on National Wildlife Refuges
outside Alaska covering 50 CFR 25.41, 25.61, 30.11, 31.13, and
31.16
FORMS: 3-1383
OMB NO: 1018-0103 EXPIRATION DATE: 03/31/2005
RESPS:24 HOURS:720 COSTS(000):$0
Conservation Order for Control of Mid-Continent Light Geese, 50
CFR 21.60
FORMS: NONE
OMB NO: 1018-0104 EXPIRATION DATE: 11/30/2005
RESPS:40 HOURS:640 COSTS(000):$0
Information Collection in support of programs authorized by the
North American Wetlands Conservation Act (NAWCA) and Council
FORMS: NONE
OMB NO: 1018-0109 EXPIRATION DATE: 01/31/2004
RESPS:5,750 HOURS:323,000 COSTS(000):$0
The Federal Aid Grant Application Booklet 50 CFR 80
FORMS: NONE
OMB NO: 1018-0110 EXPIRATION DATE: 03/31/2004
RESPS:160 HOURS:80 COSTS(000):$0
NEPA Compliance Checklist
FORMS: FWS-FORM-3-2185
OMB NO: 1018-0111 EXPIRATION DATE: 09/30/2004
RESPS:34 HOURS:17 COSTS(000):$0
Summary Information for Ranking National Coastal Wetlands Grant
Program Proposals, 50 CFR 84.
FORMS: FORM-3-2179
OMB NO: 1018-0112 EXPIRATION DATE: 11/30/2004
RESPS:400 HOURS:100 COSTS(000):$0
U.S. Fish & Wildlife Service Employee Exit Follow-up, authorized
by the Merit System Principles (5 U.S.C. 2301)
FORMS: 3-2186
OMB NO: 1018-0113 EXPIRATION DATE: 11/30/2005
RESPS:30 HOURS:1,200 COSTS(000):$0
Information collection in support of grant program authorized by
the Neotropical Migratory Bird Conservation Act (PL 106-247, 114
Stat. 593).
FORMS: NONE
OMB NO: 1018-0115 EXPIRATION DATE: 04/30/2005
RESPS:1,227 HOURS:61 COSTS(000):$0
USFWS Training Records: Application for FWS Training Request
FORMS: FORM-3-2193
OMB NO: 1018-0117 EXPIRATION DATE: 05/31/2005
RESPS:60 HOURS:30 COSTS(000):$0
State Certification of Expenditures, Public Law 106-408
FORMS: 3-2197A
OMB NO: 1018-0118 EXPIRATION DATE: 07/31/2005
RESPS:550 HOURS:4,200 COSTS(000):$0
Private Stewardship Grants Program
FORMS: NONE
OMB NO: 1018-0119 EXPIRATION DATE: 12/31/2005
RESPS:6 HOURS:16,600 COSTS(000):$0
Policy for Evaluation of Conservation Efforts When Making
Listing Decisions
FORMS: NONE
OMB NO: 1018-0120 EXPIRATION DATE: 02/28/2006
RESPS:1,020 HOURS:510 COSTS(000):$0
Federal Subsistence Regional Advisory Council Membership
Application, Nomination, & Interview Forms
FORMS: 7-FW4 7-FW5 7-FW6
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
34 4,203,915 640,229 $720
National Park Service
OMB NO: 1024-0009 EXPIRATION DATE: 05/31/2003
RESPS:3,000 HOURS:7,500 COSTS(000):$764
Historic Preservation Certification Application
FORMS: 10-168
OMB NO: 1024-0018 EXPIRATION DATE: 01/31/2005
RESPS:1,575 HOURS:56,700 COSTS(000):$0
36 CFR 60 and 63. National Register of Historic Places
Registration form; Continuation Sheet; Multiple Property
Documentation Form.
FORMS: 10-900 10-900-A 10-900B
OMB NO: 1024-0021 EXPIRATION DATE: 04/30/2004
RESPS:4,200 HOURS:2,100 COSTS(000):$0
National Capital Region Application for Public Gathering, 36 CFR
7.96(g)
FORMS: NONE
OMB NO: 1024-0022 EXPIRATION DATE: 01/31/2004
RESPS:295,339 HOURS:24,612 COSTS(000):$0
Backcountry Use Permit (36 CFR 1.5, 1.6, and 2.10)
FORMS: 10-404
OMB NO: 1024-0026 EXPIRATION DATE: 09/30/2003
RESPS:18,600 HOURS:11,150 COSTS(000):$930
Special Park Use Applications (36 CFR)
FORMS: NPS-10-939 NPS-10-931 NPS-10-932
OMB NO: 1024-0028 EXPIRATION DATE: 02/29/2004
RESPS:164 HOURS:248 COSTS(000):$0
Urban Park and Recreation Recovery Program Project Performance
Report
FORMS: CONSTR.11/80 NONCONSTR.11/80
OMB NO: 1024-0029 EXPIRATION DATE: 09/30/2003
RESPS:500 HOURS:3,800 COSTS(000):$0
Concessioner Annual Financial Report
FORMS: 10-356 10-356A 10-356B
OMB NO: 1024-0031 EXPIRATION DATE: 02/29/2004
RESPS:450 HOURS:115 COSTS(000):$0
Land and Water Conservation Fund Description and Notification
Form
FORMS: 10-903
OMB NO: 1024-0032 EXPIRATION DATE: 02/29/2004
RESPS:700 HOURS:700 COSTS(000):$0
Land and Water Conservation Fund Program Performance Report
FORMS: N/A
OMB NO: 1024-0033 EXPIRATION DATE: 02/29/2004
RESPS:450 HOURS:450 COSTS(000):$0
Land and Water Conservation Fund Project Agreement and Amendment
FORMS: 10-902 10-902A
OMB NO: 1024-0034 EXPIRATION DATE: 02/29/2004
RESPS:7,400 HOURS:3,700 COSTS(000):$0
Land and Water Conservation Fund On-Site Inspection Report
FORMS: N/A
OMB NO: 1024-0037 EXPIRATION DATE: 11/30/2004
RESPS:2,100 HOURS:1,750 COSTS(000):$0
Archeology Permits and Reports - 43 CFR parts 3 & 7
FORMS: DI-1926 DI-1991
OMB NO: 1024-0038 EXPIRATION DATE: 07/31/2004
RESPS:29,500 HOURS:21,508 COSTS(000):$0
Procedures for State, Tribal, and Local Government Historic
Preservation Programs; 36 CFR 61
FORMS: NONE
OMB NO: 1024-0047 EXPIRATION DATE: 02/29/2004
RESPS:50 HOURS:1,750 COSTS(000):$0
Land and Water Conservation Fund Conversion of Use Provisions
FORMS: N/A
OMB NO: 1024-0048 EXPIRATION DATE: 02/29/2004
RESPS:3 HOURS:75 COSTS(000):$0
Urban Park and Recreation Recovery Program Conversion of Use
Provisions
FORMS: N/A
OMB NO: 1024-0064 EXPIRATION DATE: 06/30/2003
RESPS:23 HOURS:4,048 COSTS(000):$0
36 CFR Part 9, Subpart A - Mining and Minimg Claims 36 CFR Part
9, Subpart B - Non-Federal Oil and Gas
FORMS: NONE
OMB NO: 1024-0089 EXPIRATION DATE: 02/29/2004
RESPS:20 HOURS:20 COSTS(000):$0
Urban Park and Recreation Recovery Program Project Agreement and
Amendment
FORMS: FNP10-912 FNP10-915
OMB NO: 1024-0125 EXPIRATION DATE: 08/31/2003
RESPS:240 HOURS:76,800 COSTS(000):$1,120
Submission of Offers in Response to Concession Opportunities
FORMS: NONE
OMB NO: 1024-0126 EXPIRATION DATE: 02/28/2006
RESPS:20 HOURS:1,600 COSTS(000):$5
Proposed Sale of Concession Operations (36 CFR, Part 51,.
Subpart J)
FORMS: NONE
OMB NO: 1024-0224 EXPIRATION DATE: 09/30/2004
RESPS:90,000 HOURS:15,000 COSTS(000):$0
Programmatic Approval for National Park Service-Sponsored Public
Surveys
FORMS: NONE
OMB NO: 1024-0226 EXPIRATION DATE: 07/31/2005
RESPS:790 HOURS:132 COSTS(000):$0
National Park Service Partnership Programs GPRA Information
Collections
FORMS: NONE
OMB NO: 1024-0231 EXPIRATION DATE: 11/30/2003
RESPS:758 HOURS:3,276 COSTS(000):$0
Concession Contract - 36 CFR 51
FORMS: NONE
OMB NO: 1024-0232 EXPIRATION DATE: 11/30/2003
RESPS:100 HOURS:1,000 COSTS(000):$0
NPS Underground Railroad Network to Freedom Application
FORMS: NONE
OMB NO: 1024-0233 EXPIRATION DATE: 01/31/2004
RESPS:627 HOURS:4,392 COSTS(000):$0
National Park Service leasing Program -- 36 CFR Part 18
FORMS: NONE
OMB NO: 1024-0236 EXPIRATION DATE: 04/30/2004
RESPS:6,000 HOURS:4,875 COSTS(000):$0
Application for a Scientific Research and Collecting Permit:
Investigator's Annual Report; re 36 CFR 2.1 and 2.5
FORMS: 10-741 10-226
OMB NO: 1024-0242 EXPIRATION DATE: 09/30/2004
RESPS:400 HOURS:125 COSTS(000):$0
National Park Service Urban and Adjacent Parks: Assessment and
Development of Community Outreach
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
26 463,009 247,426 $2,819
Geological Survey
OMB NO: 1028-0048 EXPIRATION DATE: 10/31/2005
RESPS:100,000 HOURS:10,000 COSTS(000):$0
Earthquake Report
FORMS: 9-3013
OMB NO: 1028-0051 EXPIRATION DATE: 11/30/2003
RESPS:370 HOURS:12,800 COSTS(000):$0
National Earthquake Hazards Reduction Program Annual Announce-
ment of Availability of Funds
FORMS: 424 269 270
OMB NO: 1028-0053 EXPIRATION DATE: 09/30/2005
RESPS:5,897 HOURS:4,791 COSTS(000):$0
Nonferrous Metals Surveys
FORMS: 32
OMB NO: 1028-0056 EXPIRATION DATE: 05/31/2004
RESPS:450 HOURS:150 COSTS(000):$0
North American Reporting Center for Amphibian Malformations
FORMS: NONE
OMB NO: 1028-0057 EXPIRATION DATE: 11/30/2003
RESPS:1,000 HOURS:350 COSTS(000):$0
The National Atlas of the United States of America
FORMS: NONE
OMB NO: 1028-0059 EXPIRATION DATE: 02/29/2004
RESPS:3,000 HOURS:750 COSTS(000):$0
Comprehensive Test Ban Treaty
FORMS: 9-4040-A
OMB NO: 1028-0060 EXPIRATION DATE: 12/31/2003
RESPS:739 HOURS:555 COSTS(000):$0
Mine, Development, and Mineral Exploration Supplement
FORMS: 9-4000-A
OMB NO: 1028-0062 EXPIRATION DATE: 02/29/2004
RESPS:19,008 HOURS:13,185 COSTS(000):$0
Industrial Minerals Survey
FORMS: NONE
OMB NO: 1028-0065 EXPIRATION DATE: 02/29/2004
RESPS:3,450 HOURS:742 COSTS(000):$0
Production Estimate, Quarterly Construction Sand and Gravel and
Crushed and Broken Stone
FORMS: 9-4042-A 9-4124-A
OMB NO: 1028-0068 EXPIRATION DATE: 09/30/2004
RESPS:3,479 HOURS:1,970 COSTS(000):$0
Ferrous Metals Surveys
FORMS: NONE
OMB NO: 1028-0069 EXPIRATION DATE: 10/31/2004
RESPS:3,000 HOURS:150 COSTS(000):$0
User Survey for National Biological Information Infrastructure
FORMS: NONE
OMB NO: 1028-0070 EXPIRATION DATE: 09/30/2004
RESPS:3,670 HOURS:2,753 COSTS(000):$0
Consolidated Consumers' Report
FORMS: 9-4117-MA
OMB NO: 1028-0072 EXPIRATION DATE: 10/31/2005
RESPS:9,000 HOURS:2,250 COSTS(000):$0
Frogwatch USA
FORMS: NONE
OMB NO: 1028-0074 EXPIRATION DATE: 07/31/2004
RESPS:700 HOURS:292 COSTS(000):$0
Assessment of the Use and Benefits of Waterfowl Production Areas
in Minnesota
FORMS: NONE
OMB NO: 1028-0075 EXPIRATION DATE: 07/31/2004
RESPS:1,000 HOURS:416 COSTS(000):$0
Understanding Visitor Uses, Motives, and Benefits at Sherburne
National Wildlife Refuge
FORMS: NONE
OMB NO: 1028-0076 EXPIRATION DATE: 07/31/2004
RESPS:1,400 HOURS:268 COSTS(000):$0
Conservation Reserve Program (CRP) Contractee Perceptions on
Environmental Benefits and Management
FORMS: NONE
OMB NO: 1028-0077 EXPIRATION DATE: 03/31/2005
RESPS:600 HOURS:150 COSTS(000):$0
Visitor knowledge and economic impact at Arapaho, Arrowwod and
Sand Lake National Wildlife Refuges
FORMS: NONE
OMB NO: 1028-0078 EXPIRATION DATE: 03/31/2005
RESPS:1,000 HOURS:7,000 COSTS(000):$0
North American Amphibian Monitoring Program
FORMS: NONE
OMB NO: 1028-0079 EXPIRATION DATE: 03/31/2005
RESPS:2,500 HOURS:12,500 COSTS(000):$0
North American Breeding Bird Survey
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
19 160,263 71,072 $0
Office of Surface Mining Reclamation and Enforcement
OMB NO: 1029-0024 EXPIRATION DATE: 08/31/2004
RESPS:65 HOURS:9,205 COSTS(000):$0
Procedures and Criteria for Approval or Disapproval of State
Program Submissions, 30 CFR PART 732
FORMS: NONE
OMB NO: 1029-0025 EXPIRATION DATE: 08/31/2003
RESPS:2 HOURS:200 COSTS(000):$0
Maintenance of State programs and procedures for substituting
Federal enforcement of State programs and withdrawing approval
of State programs, 30 CFR 733.
FORMS: NONE
OMB NO: 1029-0027 EXPIRATION DATE: 10/31/2005
RESPS:36 HOURS:2,433 COSTS(000):$0
General Requirements for Surface Coal Mining and Reclamation
Operations on Federal Lands - 30 CFR 740
FORMS: NONE
OMB NO: 1029-0030 EXPIRATION DATE: 07/31/2004
RESPS:4 HOURS:7,240 COSTS(000):$0
State processes for designating areas unsuitable for surface
coal mining operations, 30 CFR Part 764
FORMS: NONE
OMB NO: 1029-0035 EXPIRATION DATE: 06/30/2003
RESPS:315 HOURS:51,188 COSTS(000):$0
Surface Mining Permit Applications - Minimum Requirements for
Environmental Resources - Part 779
FORMS: NONE
OMB NO: 1029-0036 EXPIRATION DATE: 10/31/2005
RESPS:325 HOURS:186,556 COSTS(000):$2,878
Surface Mining Permit Applications - Minimum Requirements for
Reclamation and Operation Plans - 30 CFR Part 780
FORMS: NONE
OMB NO: 1029-0038 EXPIRATION DATE: 03/31/2006
RESPS:59 HOURS:25,088 COSTS(000):$0
Underground Mining Permit Applications - Minimum Requirements
for information on Environmental Resources - 30 CFR Part 783
FORMS: NONE
OMB NO: 1029-0039 EXPIRATION DATE: 06/30/2004
RESPS:100 HOURS:96,460 COSTS(000):$850
Underground Mining Permit Applications - Minimum Requirements
for Reclamation and Operations Plans, 30 CFR 784.
FORMS: NONE
OMB NO: 1029-0040 EXPIRATION DATE: 08/31/2003
RESPS:347 HOURS:16,372 COSTS(000):$0
30 CFR Part 785 -- Requirements for permits for special
categories of mining
FORMS: NONE
OMB NO: 1029-0043 EXPIRATION DATE: 12/31/2005
RESPS:14,167 HOURS:166,114 COSTS(000):$2,437
30 CFR Part 800 -- Bond and Insurance Requirements for Surface
Coal Mining and Reclamation Operations Under Regulatory Programs
FORMS: NONE
OMB NO: 1029-0047 EXPIRATION DATE: 02/29/2004
RESPS:731,787 HOURS:355,405 COSTS(000):$0
Permanent Program Performance Standards - Surface Mining
Activities, 30 CFR Part 816.
FORMS: NONE
OMB NO: 1029-0048 EXPIRATION DATE: 06/30/2004
RESPS:20,745 HOURS:95,618 COSTS(000):$1,272
Permanent Program Performance Standards - Underground Mining
Activities, 30 CFR Part 817
FORMS: NONE
OMB NO: 1029-0049 EXPIRATION DATE: 07/31/2004
RESPS:10 HOURS:1,000 COSTS(000):$0
Special permanent program performance standards-operations in
alluvial valley floors, 30 CFR Part 822
FORMS: NONE
OMB NO: 1029-0051 EXPIRATION DATE: 01/31/2004
RESPS:99,013 HOURS:578,509 COSTS(000):$1
Permanent Program Inspection and Enforcement Procedures, 30 CFR
Part 840.
FORMS: NONE
OMB NO: 1029-0054 EXPIRATION DATE: 08/31/2005
RESPS:1 HOURS:1 COSTS(000):$0
Abandoned mine reclamation funds - 30 CFR 872
FORMS: NONE
OMB NO: 1029-0055 EXPIRATION DATE: 05/31/2005
RESPS:20 HOURS:20 COSTS(000):$1
Rights of Entry - Part 877
FORMS: NONE
OMB NO: 1029-0057 EXPIRATION DATE: 03/31/2004
RESPS:1 HOURS:16 COSTS(000):$0
Reclamation on Private Land - 30 CFR 882
FORMS: NONE
OMB NO: 1029-0059 EXPIRATION DATE: 01/31/2006
RESPS:132 HOURS:706 COSTS(000):$0
30 CFR 735 - Grants for Program Development and Administration
and Enforcement, and 30 CFR 886 - State and Tribal Reclamation
Grants
FORMS: 47 49 51
OMB NO: 1029-0061 EXPIRATION DATE: 06/30/2003
RESPS:160 HOURS:10,635 COSTS(000):$0
Small Operator Assistance Program - Part 795
FORMS: FORM-FS-6
OMB NO: 1029-0063 EXPIRATION DATE: 06/30/2003
RESPS:15,804 HOURS:4,280 COSTS(000):$0
Coal Production and Reclamation Fee Report
FORMS: OSM-1
OMB NO: 1029-0067 EXPIRATION DATE: 08/31/2005
RESPS:2,909 HOURS:974 COSTS(000):$0
Statement of Employment and Financial Interests for Use by State
Employees - 30 CFR Part 705
FORMS: OSM-23
OMB NO: 1029-0080 EXPIRATION DATE: 03/31/2004
RESPS:1 HOURS:173 COSTS(000):$0
Permanent regulatory program requirements-standards for
certification of blasters, 30 CFR 850
FORMS: NONE
OMB NO: 1029-0083 EXPIRATION DATE: 08/31/2005
RESPS:33 HOURS:57 COSTS(000):$3
Application for Blaster Certification in Federal Program States
and Indian Lands - 30 CFR Part 955
FORMS: OSM-74
OMB NO: 1029-0087 EXPIRATION DATE: 03/31/2004
RESPS:1,800 HOURS:4,000 COSTS(000):$0
Abandoned Mine Land Problem Area Description Form, OSM 76
FORMS: OSM-76
OMB NO: 1029-0089 EXPIRATION DATE: 03/31/2004
RESPS:61 HOURS:513 COSTS(000):$0
Exemption for Coal Extraction Incidental to the Extraction of
Other Minerals, 30 CFR Part 702
FORMS: NONE
OMB NO: 1029-0090 EXPIRATION DATE: 01/31/2006
RESPS:933 HOURS:700 COSTS(000):$0
Abandoned Mine Reclamation Fund - Fee Collection and Coal Pro-
duction Reporting - 30 CFR 870.18
FORMS: NONE
OMB NO: 1029-0091 EXPIRATION DATE: 05/31/2005
RESPS:75 HOURS:1,400 COSTS(000):$15
Requirements for Surface Coal Mining and Reclamation Operations
on Indian Lands-30 CFR 750
FORMS: NONE
OMB NO: 1029-0092 EXPIRATION DATE: 10/31/2005
RESPS:12 HOURS:454 COSTS(000):$0
State-Federal cooperative agreements - 30 CFR 745
FORMS: NONE
OMB NO: 1029-0094 EXPIRATION DATE: 11/30/2003
RESPS:6 HOURS:12 COSTS(000):$0
General - 30 CFR Part 700
FORMS: NONE
OMB NO: 1029-0098 EXPIRATION DATE: 11/30/2003
RESPS:1 HOURS:120 COSTS(000):$0
Petition process for designation of Federal lands as unsuitable
for all or certain types of surface coal mining operations and
for termination of previous designation - 30 CFR 769
FORMS: NONE
OMB NO: 1029-0103 EXPIRATION DATE: 09/30/2003
RESPS:7 HOURS:340 COSTS(000):$0
Noncoal Reclamation - 30 CFR 875
FORMS: NONE
OMB NO: 1029-0104 EXPIRATION DATE: 08/31/2003
RESPS:1 HOURS:350 COSTS(000):$0
Acid Mine Drainage Treatment of Abatement Program - 30 CFR 876
FORMS: NONE
OMB NO: 1029-0107 EXPIRATION DATE: 10/31/2005
RESPS:1 HOURS:8 COSTS(000):$0
Subsidence Insurance Program Grants - 30 CFR Part 887
FORMS: NONE
OMB NO: 1029-0110 EXPIRATION DATE: 06/30/2003
RESPS:315 HOURS:53 COSTS(000):$0
Technical Training Program Course Effectiveness Evaluation
FORMS: NONE
OMB NO: 1029-0111 EXPIRATION DATE: 12/31/2005
RESPS:262 HOURS:1,864 COSTS(000):$12
Areas Designated by Act of Congress - 30 CFR Part 761
FORMS: NONE
OMB NO: 1029-0112 EXPIRATION DATE: 12/31/2005
RESPS:905 HOURS:8,510 COSTS(000):$1
30 CFR Part 772 -- Requirements for Coal Exploration
FORMS: NONE
OMB NO: 1029-0113 EXPIRATION DATE: 08/31/2004
RESPS:45 HOURS:3,240 COSTS(000):$0
General Reclamation Requirements 30 CFR 874
FORMS: NONE
OMB NO: 1029-0114 EXPIRATION DATE: 11/30/2004
RESPS:750 HOURS:125 COSTS(000):$0
Technical Evaluations Series
FORMS: NONE
OMB NO: 1029-0115 EXPIRATION DATE: 12/31/2003
RESPS:310 HOURS:11,116 COSTS(000):$12
Requirements for permits and permit processing - 30 CFR Part 773
FORMS: NONE
OMB NO: 1029-0116 EXPIRATION DATE: 12/31/2003
RESPS:12,090 HOURS:97,780 COSTS(000):$0
Revision; Renewal; and Transfer, Assignment, or Sale of Permit
Rights - 30 CFR 774
FORMS: NONE
OMB NO: 1029-0117 EXPIRATION DATE: 12/31/2003
RESPS:310 HOURS:8,437 COSTS(000):$0
Permit Applications - minimum requirements for legal, financial,
compliance, and related information-Part 778
FORMS: NONE
OMB NO: 1029-0118 EXPIRATION DATE: 06/30/2005
RESPS:126 HOURS:95 COSTS(000):$0
Federal inspections and monitoring - 30 CFR Part 842
FORMS: NONE
OMB NO: 1029-0119 EXPIRATION DATE: 11/30/2003
RESPS:519 HOURS:465 COSTS(000):$0
Abandoned Mine Land Contractor Information Form
FORMS: NONE
OMB NO: 1029-0120 EXPIRATION DATE: 01/31/2004
RESPS:1,600 HOURS:134 COSTS(000):$0
Technical Training Program Course Nomination and Payment for
Travel and Per Diem Forms
FORMS: OSM-105 OSM-140
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
44 906,165 1,747,966 $7,482
Office of the Special Trustee
OMB NO: 1035-0001 EXPIRATION DATE: 05/31/2003
RESPS:12 HOURS:468 COSTS(000):$0
Application for Technical Assistance to Withdraw Tribal Funds
from Trust Status (Specific Budget)
FORMS: SF-424A
OMB NO: 1035-0002 EXPIRATION DATE: 05/31/2003
RESPS:12 HOURS:156 COSTS(000):$0
Application for assistance to withdraw Tribal funds from Trust
Status (General)
FORMS: SF-424
OMB NO: 1035-0003 EXPIRATION DATE: 05/31/2003
RESPS:12 HOURS:4,104 COSTS(000):$0
Application to Withdraw Tribal funds from Trust Status
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
3 36 4,728 $0
Office of Planning and Performance Management
OMB NO: 1040-0001 EXPIRATION DATE: 01/31/2005
RESPS:120,000 HOURS:18,000 COSTS(000):$0
DOI Programmatic Clearance for Customer Satisfaction Surveys
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
1 120,000 18,000 $0
Office of Historical Trust Accounting
OMB NO: 1050-0001 EXPIRATION DATE: 04/30/2003
RESPS:2,000 HOURS:8,000 COSTS(000):$0
Cobell v. Norton Litigation; project to correct "Collection of
Missing Information" breach of trust duty.
FORMS: NONE
OMB NO: 1050-0002 EXPIRATION DATE: 04/30/2003
RESPS:40 HOURS:40 COSTS(000):$0
Pilot Testing of Individual Indian Money Account-holder Customer
Feedback Methods for Historical Accounting (Previously approved
as OMB #1090-0004)
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
2 2,040 8,040 $0
Bureau of Indian Affairs
OMB NO: 1076-0017 EXPIRATION DATE: 07/31/2005
RESPS:200,000 HOURS:50,000 COSTS(000):$0
Financial Assistance & Social Services Program 25 CFR 20
FORMS: 5-6601
OMB NO: 1076-0018 EXPIRATION DATE: 02/28/2006
RESPS:25 HOURS:25 COSTS(000):$0
Tribal Colleges and Universities Grant Application Form 25 CFR
41.8
FORMS: 62107
OMB NO: 1076-0020 EXPIRATION DATE: 10/31/2003
RESPS:852 HOURS:519 COSTS(000):$0
25 CFR 103- Loan Guaranty, Insurance, and Interest Subsidy
FORMS: 5-4749 5-4753 5-4754 5-4755 5-4759 5-4760
OMB NO: 1076-0021 EXPIRATION DATE: 04/30/2003
RESPS:4,750 HOURS:1,188 COSTS(000):$0
Electrical Service Application -- 25 CFR 175
FORMS: NONE
OMB NO: 1076-0062 EXPIRATION DATE: 04/30/2003
RESPS:4,900 HOURS:2,450 COSTS(000):$0
Application for Training or Employment
FORMS: BIA-8205
OMB NO: 1076-0084 EXPIRATION DATE: 10/31/2004
RESPS:3,500 HOURS:1,750 COSTS(000):$0
25 CFR 256 United States Department of the Interior, Burau of
Indian Affairs Housing Improvement Program
FORMS: BIA-6407
OMB NO: 1076-0094 EXPIRATION DATE: 06/30/2005
RESPS:260 HOURS:65 COSTS(000):$0
Title 25 CFR 11, Subpart F, Law & Order on Indian Reservations
FORMS: NONE
OMB NO: 1076-0096 EXPIRATION DATE: 09/30/2005
RESPS:360 HOURS:1,800 COSTS(000):$0
Education Contracts under Johnson O'Malley Act Application and
regulatory Requirements, 25 CFR 273.50
FORMS: BIA-NO-62118
OMB NO: 1076-0100 EXPIRATION DATE: 12/31/2003
RESPS:9,200 HOURS:36,800 COSTS(000):$0
25 CFR 151, Acquisition of Title to Land in Trust
FORMS: NONE
OMB NO: 1076-0101 EXPIRATION DATE: 10/31/2004
RESPS:14,000 HOURS:14,000 COSTS(000):$0
Higher Education Grant Application 25 CFR 40
FORMS: 6237
OMB NO: 1076-0104 EXPIRATION DATE: 09/30/2003
RESPS:10 HOURS:22,377 COSTS(000):$0
Documented Petitions for Federal Acknowledgment as an Indian
Tribe, 25 CFR 83
FORMS: 8304 8305 8306
OMB NO: 1076-0105 EXPIRATION DATE: 02/28/2006
RESPS:25 HOURS:75 COSTS(000):$0
Tribal Colleges and Universities Annual Report Form 25 CFR 41.9
FORMS: 6259
OMB NO: 1076-0106 EXPIRATION DATE: 10/31/2004
RESPS:125 HOURS:375 COSTS(000):$0
Higher Education Annual Report, 25 CFR 40 Subchapter E
FORMS: NONE
OMB NO: 1076-0111 EXPIRATION DATE: 10/31/2003
RESPS:4 HOURS:12 COSTS(000):$0
25 CFR 23.13, Payment for Appointed Counsel in Involuntary
Indian Child Custody Proceedings in State Courts
FORMS: NONE
OMB NO: 1076-0112 EXPIRATION DATE: 04/30/2003
RESPS:2 HOURS:16 COSTS(000):$0
Contents of Reassumption Petition -- 25 CFR 13.11
FORMS: NONE
OMB NO: 1076-0114 EXPIRATION DATE: 10/31/2005
RESPS:3,943 HOURS:2,214 COSTS(000):$15
Application for Admission to Haskell Indian Nations University
and to Southwestern Indian Polytechnic Institure
FORMS: NONE
OMB NO: 1076-0120 EXPIRATION DATE: 01/31/2005
RESPS:70 HOURS:280 COSTS(000):$0
Adult Education Annual Report Form
FORMS: 6-2123
OMB NO: 1076-0122 EXPIRATION DATE: 08/31/2005
RESPS:48,000 HOURS:12,000 COSTS(000):$0
Data Elements for Student Enrollment in Bureau - funded Schools
FORMS: NONE
OMB NO: 1076-0131 EXPIRATION DATE: 01/31/2005
RESPS:2,144 HOURS:1,072 COSTS(000):$0
Indian Child Welfare Assistance Annual Report (25 CFR 23/47)
FORMS: NONE
OMB NO: 1076-0134 EXPIRATION DATE: 12/31/2005
RESPS:121 HOURS:726 COSTS(000):$0
Student Transportation Form, Subpart H, 25 CFR 39.100 - 103
FORMS: NONE
OMB NO: 1076-0135 EXPIRATION DATE: 06/30/2003
RESPS:37 HOURS:370 COSTS(000):$0
A Reporting System for P.L. 102-477 Deomonstration Project
FORMS: NONE
OMB NO: 1076-0136 EXPIRATION DATE: 09/30/2003
RESPS:5,507 HOURS:238,992 COSTS(000):$0
Indian Self-Determination and Education Assistance Act Programs
FORMS: NONE
OMB NO: 1076-0141 EXPIRATION DATE: 04/30/2003
RESPS:51,500 HOURS:4,292 COSTS(000):$0
Water Request -- 25 CFR 171
FORMS: NONE
OMB NO: 1076-0143 EXPIRATION DATE: 04/30/2003
RESPS:257 HOURS:10,766 COSTS(000):$16
Tribal Self-Governance Program, 25 CFR Part 1000
FORMS: NONE
OMB NO: 1076-0146 EXPIRATION DATE: 06/30/2005
RESPS:70 HOURS:1,680 COSTS(000):$0
Evaluation of the performance of trust functions performed by
tribes under self-governance compacts, 25 CFR 1000, Subpart O
FORMS: NONE
OMB NO: 1076-0147 EXPIRATION DATE: 05/31/2005
RESPS:280 HOURS:140 COSTS(000):$0
U.S. Department of the Interior, Bureau of Indian Affairs Indian
Service Population and Labor Force Estimates Report
FORMS: NONE
OMB NO: 1076-0149 EXPIRATION DATE: 04/30/2003
RESPS:12 HOURS:3,840 COSTS(000):$0
Class III Gaming Procedures 25 CFR 522
FORMS: NONE
OMB NO: 1076-0152 EXPIRATION DATE: 04/30/2003
RESPS:50 HOURS:5,000 COSTS(000):$0
Tribal Revenue Allocation Plans 25 CFR 290
FORMS: NONE
OMB NO: 1076-0153 EXPIRATION DATE: 06/30/2003
RESPS:287,400 HOURS:433,500 COSTS(000):$0
Request for Certificate of Degree of Indian or Alaska Native
Blood, 25 CFR Part 70
FORMS: NONE
OMB NO: 1076-0154 EXPIRATION DATE: 10/31/2003
RESPS:1,997,500 HOURS:1,577,125 COSTS(000):$0
Funds Held in Trust for Tribes and Individuals 25 CFR-115
FORMS: NONE
OMB NO: 1076-0155 EXPIRATION DATE: 09/30/2003
RESPS:79,843 HOURS:70,237 COSTS(000):$0
Leases and Permits 25 CFR 162
FORMS: NONE
OMB NO: 1076-0156 EXPIRATION DATE: 09/30/2003
RESPS:32,589 HOURS:156,407 COSTS(000):$60
Probate of Indian Estates, Except for Members of the Five
Civilized Tribes 25 CFR 15
FORMS: NONE
OMB NO: 1076-0157 EXPIRATION DATE: 09/30/2003
RESPS:4,200 HOURS:3,088 COSTS(000):$0
Grazing Permits 25 CFR 166
FORMS: 5-5513 5-5514 5-5515 5-5516 5-5517 5-5519 5-5423 5-5522 5-5523
5-5524
OMB NO: 1076-0158 EXPIRATION DATE: 11/30/2003
RESPS:2 HOURS:2,000 COSTS(000):$0
Gaming on Trust Lands Acquired After October 17, 1988 25 CFR 292
FORMS: NONE
OMB NO: 1076-0159 EXPIRATION DATE: 03/31/2004
RESPS:1,325 HOURS:68,035 COSTS(000):$0
25 CFR 151, Acquisition of Title to Land in Trust and Tribal
Land Acquisition Area
FORMS: NONE
OMB NO: 1076-0160 EXPIRATION DATE: 05/31/2005
RESPS:5,000 HOURS:2,500 COSTS(000):$6
Verification of Indian Preference for Employment in BIA & IHS
FORMS: BIA-4432
OMB NO: 1076-0161 EXPIRATION DATE: 10/31/2005
RESPS:557 HOURS:31,470 COSTS(000):$0
25 CFR 170, Indian Reservation Roads
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
37 2,758,420 2,757,186 $97
Office of Acquisition and Property Management
OMB NO: 1084-0010 EXPIRATION DATE: 02/28/2006
RESPS:200 HOURS:88 COSTS(000):$0
Claim for Relocation Payments - Residential, DI-381 Claim for
Relocation Payments - Nonresidential, DI-382
FORMS: 381 382
OMB NO: 1084-0033 EXPIRATION DATE: 01/31/2004
RESPS:5,279 HOURS:1,046 COSTS(000):$0
Private Rental Survey
FORMS: OS-2000 OS-2001
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
2 5,479 1,134 $0
Indian Arts and Crafts Board
OMB NO: 1085-0001 EXPIRATION DATE: 06/30/2005
RESPS:100 HOURS:25 COSTS(000):$0
Source Directory of American Indian and Alaska Native owned and
operated arts & crafts businesses
FORMS: NONE
OMB NO: 1085-0002 EXPIRATION DATE: 06/30/2005
RESPS:580 HOURS:97 COSTS(000):$0
Non-member Indian Artisan Certification Program - 25 CFR 309
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
2 680 122 $0
Office for Equal Opportunity
OMB NO: 1091-0001 EXPIRATION DATE: 03/31/2006
RESPS:560,000 HOURS:46,480 COSTS(000):$0
US Department of the Interior, Applicant Background Survey
FORMS: 1935
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
1 560,000 46,480 $0
AGENCY TOTALS:
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
303 13,387,603 7,956,705 $33,281
Department of Justice
General Administration
OMB NO: 1103-0016 EXPIRATION DATE: 02/29/2004
RESPS:153,333 HOURS:38,333 COSTS(000):$77
Certification of Identify
FORMS: DOJ-361
OMB NO: 1103-0018 EXPIRATION DATE: 02/29/2004
RESPS:7,462 HOURS:149,240 COSTS(000):$0
Department of Justice Procurement Blanket Clearance
FORMS: NONE
OMB NO: 1103-0019 EXPIRATION DATE: 09/30/2003
RESPS:2,500 HOURS:62,500 COSTS(000):$0
COPS Making Officer Redeployment Effective (MORE) Grant Program
Application Kit.
FORMS: NONE
OMB NO: 1103-0027 EXPIRATION DATE: 09/30/2003
RESPS:3,500 HOURS:31,500 COSTS(000):$0
COPS Universal Hiring Program (UHP) and COPS in Schools (CIS)
Grant Applications
FORMS: NONE
OMB NO: 1103-0030 EXPIRATION DATE: 04/30/2003
RESPS:1,600 HOURS:2,400 COSTS(000):$0
COPS Department Initial Report
FORMS: COPS-012/01
OMB NO: 1103-0037 EXPIRATION DATE: 06/30/2003
RESPS:1,830 HOURS:9,150 COSTS(000):$0
COPS MORE (Making Officer Redeployment Effective) '98 Progress
Report
FORMS: NONE
OMB NO: 1103-0043 EXPIRATION DATE: 10/31/2003
RESPS:128 HOURS:1,472 COSTS(000):$0
Regional Community Policing Institute Quarterly Progress Report
FORMS: 022/01
OMB NO: 1103-0061 EXPIRATION DATE: 02/29/2004
RESPS:23,118 HOURS:11,559 COSTS(000):$0
COPS Grant Status Survey
FORMS: 301/02
OMB NO: 1103-0066 EXPIRATION DATE: 02/29/2004
RESPS:10,000 HOURS:2,500 COSTS(000):$0
National Center for Victims of Crime: Service Referral
Questionnaire
FORMS: COPS/PPSE/02
OMB NO: 1103-0067 EXPIRATION DATE: 05/31/2003
RESPS:1,550 HOURS:975 COSTS(000):$0
COPS Crime Analysis Unit Survey
FORMS: COPS-034/01
OMB NO: 1103-0072 EXPIRATION DATE: 01/31/2005
RESPS:200 HOURS:1,800 COSTS(000):$0
Tribal Resources Grant Program Application
FORMS: NONE
OMB NO: 1103-0078 EXPIRATION DATE: 09/30/2005
RESPS:10 HOURS:35 COSTS(000):$0
Mental Health and Community Safety Initiative Equipment and
Training Progress Report
FORMS: NONE
OMB NO: 1103-0079 EXPIRATION DATE: 09/30/2005
RESPS:2,800 HOURS:1,400 COSTS(000):$0
COPS In Schools/Safe Schools Healthy Students Annual Report
FORMS: NONE
OMB NO: 1103-0080 EXPIRATION DATE: 07/31/2005
RESPS:10 HOURS:15 COSTS(000):$0
Mental Health and Community Safety Initiative Hiring Progress
Report
FORMS: NONE
OMB NO: 1103-0081 EXPIRATION DATE: 09/30/2005
RESPS:6,100 HOURS:6,100 COSTS(000):$0
Department Annual Report
FORMS: NONE
OMB NO: 1103-0082 EXPIRATION DATE: 10/31/2003
RESPS:200 HOURS:5,200 COSTS(000):$0
Technology Initiative Grant Application Kit
FORMS: NONE
OMB NO: 1103-0083 EXPIRATION DATE: 10/31/2003
RESPS:100 HOURS:900 COSTS(000):$0
Secure Our Schools Act Grant Application Kit
FORMS: NONE
OMB NO: 1103-0084 EXPIRATION DATE: 10/31/2003
RESPS:100 HOURS:1,500 COSTS(000):$0
Methamphetamine Discretionary Grant Program Application
FORMS: NONE
OMB NO: 1103-0085 EXPIRATION DATE: 10/31/2003
RESPS:200 HOURS:1,800 COSTS(000):$0
Community Policing Development Proposal Packet
FORMS: NONE
OMB NO: 1103-0086 EXPIRATION DATE: 10/31/2003
RESPS:200 HOURS:300 COSTS(000):$0
Tribal Resources Grant Program Hiring Progress Report
FORMS: NONE
OMB NO: 1103-0087 EXPIRATION DATE: 10/31/2003
RESPS:200 HOURS:600 COSTS(000):$0
Tribal Resources Grant Program Equipment and Training Progress
Report
FORMS: NONE
OMB NO: 1103-0088 EXPIRATION DATE: 10/31/2003
RESPS:15 HOURS:37 COSTS(000):$0
Tribal Hiring Renewal Grant Program Application
FORMS: NONE
OMB NO: 1103-0089 EXPIRATION DATE: 01/31/2006
RESPS:160 HOURS:2,560 COSTS(000):$0
Public Safety/Crime Prevention Proposal Kit
FORMS: NONE
OMB NO: 1103-0090 EXPIRATION DATE: 01/31/2006
RESPS:1,835 HOURS:3,239 COSTS(000):$0
Making Officer Redeployment Effective (MORE) Closeout Report
FORMS: NONE
OMB NO: 1103-0091 EXPIRATION DATE: 01/31/2006
RESPS:100 HOURS:325 COSTS(000):$0
Methamphetamine Project Final Update Report
FORMS: NONE
OMB NO: 1103-0092 EXPIRATION DATE: 01/31/2006
RESPS:100 HOURS:325 COSTS(000):$0
Methamphetamine Project, Status Update Report (SUR)
FORMS: NONE
OMB NO: 1103-0093 EXPIRATION DATE: 03/31/2006
RESPS:4,000 HOURS:2,000 COSTS(000):$0
Universal Hiring Program Extension Request Worksheet
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
27 221,351 337,765 $77
Legal Activities
OMB NO: 1105-0001 EXPIRATION DATE: 04/30/2004
RESPS:54 HOURS:81 COSTS(000):$0
Registration Statement of Individuals (Foreign Agents)
FORMS: OBD-63(CRM) FORM-CRM-153
OMB NO: 1105-0002 EXPIRATION DATE: 04/30/2004
RESPS:1,034 HOURS:1,421 COSTS(000):$0
Supplemental Registration Statement of Individuals (Foreign
Agents)
FORMS: OBD-64 FORM-CRM-154
OMB NO: 1105-0003 EXPIRATION DATE: 04/30/2004
RESPS:127 HOURS:62 COSTS(000):$0
Exhibit A to Registration Statement (Foreign Agents)
FORMS: OBD-67 FORM-CRM-157
OMB NO: 1105-0004 EXPIRATION DATE: 04/30/2004
RESPS:175 HOURS:262 COSTS(000):$0
Amendment to Registration or Supplemental Registration Reports
(Foreign Agents)
FORMS: OBD-68 CRM FORM-CRM-158
OMB NO: 1105-0007 EXPIRATION DATE: 04/30/2004
RESPS:127 HOURS:41 COSTS(000):$0
Exhibit B to Registration Statement (Foreign Agents)
FORMS: OBD-65(CRM) FORM-CRM-155
OMB NO: 1105-0008 EXPIRATION DATE: 05/31/2005
RESPS:300,000 HOURS:1,800,000 COSTS(000):$0
Claim for Damage, Injury, or Death
FORMS: SF-95
OMB NO: 1105-0013 EXPIRATION DATE: 04/30/2004
RESPS:388 HOURS:166 COSTS(000):$0
Short-form Registration Statement of Individuals (Foreign Agents)
FORMS: OBD-66 FORM-CRM-156
OMB NO: 1105-0025 EXPIRATION DATE: 10/31/2005
RESPS:20 HOURS:40 COSTS(000):$0
Department of Justice Federal Coal Lease Review Information
FORMS: ATR-139 ATR-140
OMB NO: 1105-0030 EXPIRATION DATE: 07/31/2004
RESPS:4,500 HOURS:4,500 COSTS(000):$0
Application Booklets-Attorney General's Honor Program; Summer
Law Intern Program
FORMS: NONE
OMB NO: 1105-0052 EXPIRATION DATE: 07/31/2005
RESPS:3,000 HOURS:7,500 COSTS(000):$0
Claims Under the Radiation Exposure Compensation Act
FORMS: NONE
OMB NO: 1105-0072 EXPIRATION DATE: 02/28/2005
RESPS:1,000 HOURS:500 COSTS(000):$0
Applicant Qualification Form
FORMS: NONE
OMB NO: 1105-0073 EXPIRATION DATE: 09/30/2005
RESPS:5,000 HOURS:30,000 COSTS(000):$0
Registration/Eligibility Form and Application for Emergency
Benefits from the Victim Compensation Fund
FORMS: SM-001
OMB NO: 1105-0074 EXPIRATION DATE: 01/31/2006
RESPS:203,500 HOURS:25,050 COSTS(000):$0
Flight Training Candidate Checks Program
FORMS: FTTTF-1 FTTTF-2
OMB NO: 1105-0077 EXPIRATION DATE: 10/31/2005
RESPS:250 HOURS:500 COSTS(000):$0
Victim Compensation Fund Objection Form
FORMS: SM-002
OMB NO: 1105-0078 EXPIRATION DATE: 10/31/2005
RESPS:5,000 HOURS:75,000 COSTS(000):$500
The Death Compensation form for the September 11 Victim
Compensation Fund and The Personal Injury Compensation Form for
the September 11 Victim Compensation Fund
FORMS: SM-003
OMB NO: 1105-0079 EXPIRATION DATE: 06/30/2003
RESPS:2,000 HOURS:1,000 COSTS(000):$0
Application for Representative Payee
FORMS: NONE
OMB NO: 1105-0080 EXPIRATION DATE: 09/30/2003
RESPS:400 HOURS:400 COSTS(000):$20
Annuity Broker Qualification Declaration Form
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
17 526,575 1,946,523 $520
Federal Bureau of Investigation
OMB NO: 1110-0001 EXPIRATION DATE: 09/30/2003
RESPS:212,004 HOURS:74,201 COSTS(000):$449
Return A-Monthly Return of Offenses known to Police and
Supplement to Return A-Monthly Return of Offenses known to
Police.
FORMS: 4-927A 4-919
OMB NO: 1110-0002 EXPIRATION DATE: 07/31/2004
RESPS:201,456 HOURS:30,218 COSTS(000):$0
Supplementary Homicide Report
FORMS: I-704
OMB NO: 1110-0004 EXPIRATION DATE: 09/30/2005
RESPS:16,825 HOURS:2,243 COSTS(000):$0
Full-Time Law Enforcement Employee as of October 31
FORMS: 1-711 1-711A 1-711B
OMB NO: 1110-0005 EXPIRATION DATE: 10/31/2005
RESPS:403,800 HOURS:201,900 COSTS(000):$0
Age, Sex and Race of person arrested (18 years of age and over)
Age, sex, and Race of person arrested (Under 18 years of age)
FORMS: 1-708 1-708A
OMB NO: 1110-0006 EXPIRATION DATE: 02/29/2004
RESPS:212,004 HOURS:24,734 COSTS(000):$0
Law Enforcement Officers Killed and Assaulted
FORMS: I-750
OMB NO: 1110-0008 EXPIRATION DATE: 09/30/2005
RESPS:201,900 HOURS:30,285 COSTS(000):$0
Monthly Return of Arson Offenses Known to Law Enforcement
FORMS: 1-725
OMB NO: 1110-0009 EXPIRATION DATE: 02/29/2004
RESPS:570 HOURS:570 COSTS(000):$0
Analysis of Law Enforcement Officers Killed And Assaulted
FORMS: I-701
OMB NO: 1110-0011 EXPIRATION DATE: 12/31/2004
RESPS:10,000 HOURS:10,000 COSTS(000):$0
VICAP Crime Analysis Report
FORMS: FD-676-REV
OMB NO: 1110-0015 EXPIRATION DATE: 09/30/2003
RESPS:106,002 HOURS:15,900 COSTS(000):$216
Hate Crime Incident Report/Quarterly Hate Crime Report
FORMS: 11-1 11-2
OMB NO: 1110-0016 EXPIRATION DATE: 06/30/2005
RESPS:50,000 HOURS:500,000 COSTS(000):$0
Application for employment/Federal Bureau of Investigation
FORMS: FD-140
OMB NO: 1110-0022 EXPIRATION DATE: 04/30/2003
RESPS:11,500 HOURS:46,000 COSTS(000):$0
Cost Recovery Regulations, Communications Assistance for Law
Enforcement Act of 1994
FORMS: NONE
OMB NO: 1110-0030 EXPIRATION DATE: 04/30/2003
RESPS:5,000 HOURS:21,250 COSTS(000):$0
Flexible Deployment Assistance Guide
FORMS: NONE
OMB NO: 1110-0031 EXPIRATION DATE: 05/31/2003
RESPS:3,200 HOURS:1,600 COSTS(000):$0
Emergency Law Enforcement Services Vulnerability Survey
FORMS: NONE
OMB NO: 1110-0033 EXPIRATION DATE: 05/31/2004
RESPS:250,000 HOURS:8,333 COSTS(000):$0
National Sex: Offender Registry
FORMS: NONE
OMB NO: 1110-0036 EXPIRATION DATE: 01/31/2005
RESPS:150,000 HOURS:702,000 COSTS(000):$0
National Stolen Passenger Motor Vehicle Information System
FORMS: NONE
OMB NO: 1110-0037 EXPIRATION DATE: 05/31/2003
RESPS:10,000 HOURS:10,000 COSTS(000):$0
VICAP Sexual Assault Crime Analysis Report
FORMS: NONE
OMB NO: 1110-0039 EXPIRATION DATE: 09/30/2003
RESPS:20,000 HOURS:10,000 COSTS(000):$0
Bioterrorism Preparedness Act: Entity/Individual Information
FORMS: FD-961
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
17 1,864,261 1,689,234 $665
Immigration and Naturalization Service
OMB NO: 1115-0015 EXPIRATION DATE: 04/30/2003
RESPS:22,567 HOURS:20,671 COSTS(000):$3,272
Application for Replacement Naturalization/Citizenship Document
FORMS: N-565
OMB NO: 1115-0068 EXPIRATION DATE: 04/30/2003
RESPS:3,000 HOURS:249 COSTS(000):$0
Notice to Student or Exchange Visitor
FORMS: I-515
OMB NO: 1115-0078 EXPIRATION DATE: 04/30/2003
RESPS:720,000 HOURS:129,600 COSTS(000):$0
Aircraft/Vessel Report
FORMS: I-92
OMB NO: 1115-0083 EXPIRATION DATE: 04/30/2003
RESPS:95,000 HOURS:95,000 COSTS(000):$0
Passenger List, Crew List
FORMS: I-418
OMB NO: 1115-0238 EXPIRATION DATE: 06/30/2004
RESPS:10 HOURS:40 COSTS(000):$2
Application for Authorization to Issue Health Care Certificates
FORMS: I-905
OMB NO: 1115-0253 EXPIRATION DATE: 08/31/2004
RESPS:1,500 HOURS:1,500 COSTS(000):$273
Application for Citizenship and Issuance of Certificate Under
Section 322
FORMS: N-600K
OMB NO: 1115-0254 EXPIRATION DATE: 04/30/2003
RESPS:140,000 HOURS:70,000 COSTS(000):$0
National Security Entry-Exit Registration System
FORMS: NONE
OMB NO: 1115-0255 EXPIRATION DATE: 04/30/2003
RESPS:600 HOURS:36,500 COSTS(000):$0
Visa Waiver Program Passenger Arrival and Departure Data
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
8 982,677 353,560 $3,547
Drug Enforcement Administration
OMB NO: 1117-0001 EXPIRATION DATE: 01/31/2005
RESPS:6,151 HOURS:3,076 COSTS(000):$0
Report of Theft or Loss of Controlled Substances--DEA Form 106
FORMS: FORM-106
OMB NO: 1117-0003 EXPIRATION DATE: 03/31/2005
RESPS:5,630 HOURS:1,700 COSTS(000):$0
ARCOS Transaction Reporting--DEA Form 333
FORMS: FORM-333
OMB NO: 1117-0004 EXPIRATION DATE: 01/31/2005
RESPS:2,000 HOURS:1,034 COSTS(000):$0
Application for Permit to Export Controlled Substances--DEA Form
161
FORMS: FORM-161
OMB NO: 1117-0006 EXPIRATION DATE: 03/31/2006
RESPS:264 HOURS:132 COSTS(000):$0
Application for Individual Manufacturing Quota for a Basic Class
of Controlled Substance
FORMS: 189
OMB NO: 1117-0007 EXPIRATION DATE: 01/31/2005
RESPS:20,000 HOURS:10,000 COSTS(000):$0
Registrants Inventory of Drugs Surrendered--DEA Form 41
FORMS: FORM-41
OMB NO: 1117-0008 EXPIRATION DATE: 03/31/2006
RESPS:818 HOURS:818 COSTS(000):$0
Application for Procurement Quota for Controlled Substances
FORMS: 250
OMB NO: 1117-0009 EXPIRATION DATE: 01/31/2005
RESPS:2,864 HOURS:1,432 COSTS(000):$0
Controlled Substances Import/Export Declaration--DEA Form 236
FORMS: FORM-236
OMB NO: 1117-0010 EXPIRATION DATE: 03/31/2005
RESPS:663,523 HOURS:193,508 COSTS(000):$10,279
U.S. Official Order Forms for Schedules I and II Controlled
Substances (ACCOUNTABLE FORMS), Order Form Requisition
FORMS: DEA-222 DEA-222A
OMB NO: 1117-0012 EXPIRATION DATE: 10/31/2005
RESPS:11,379 HOURS:5,693 COSTS(000):$1,376
Application for Registration (DEA Form 225); Application for
Registration Renewal (DEA Form 225a); Affidavit for Chain
Renewal (DEA Form 225B)
FORMS: 225 225A 225B
OMB NO: 1117-0013 EXPIRATION DATE: 06/30/2004
RESPS:320 HOURS:86 COSTS(000):$0
Application for Permit to Import Controlled Substances for
Domestic and/or Scientific Purposes pursuant to 21 U.S.C. 952
FORMS: FORM-357
OMB NO: 1117-0014 EXPIRATION DATE: 10/31/2005
RESPS:425,009 HOURS:85,232 COSTS(000):$85,739
Application for Registration (DEA Form 224); Application for
Registration Renewal (DEA Form 224a); and Affidavit for Chain
Renewal DEA Retail Pharmacy Registration (DEA Form 224B)
FORMS: 224 224A 224B
OMB NO: 1117-0015 EXPIRATION DATE: 10/31/2005
RESPS:1,251 HOURS:626 COSTS(000):$80
Application for Registration (DEA Form 363), Application for
Registration Renewal (DEA Form 363a), Application for
Registration Renewal (Chain) (DEA Form 363b)
FORMS: 363 363A 363B
OMB NO: 1117-0021 EXPIRATION DATE: 03/31/2005
RESPS:500 HOURS:50,250 COSTS(000):$0
Records and Reports of Registrants: Changes in Record
Requirements for Individual Practitioners
FORMS: NONE
OMB NO: 1117-0023 EXPIRATION DATE: 02/28/2005
RESPS:7,000 HOURS:1,600 COSTS(000):$0
Import/Export Declaration: Precursor and Essential Chemicals
FORMS: FORM-486
OMB NO: 1117-0024 EXPIRATION DATE: 03/31/2005
RESPS:1,996 HOURS:499 COSTS(000):$0
Reports of Suspicious Orders or Theft/Loss of Listed Chemicals/
Machines
FORMS: NONE
OMB NO: 1117-0029 EXPIRATION DATE: 09/30/2003
RESPS:100 HOURS:400 COSTS(000):$0
Annual Reporting Requirement for Manufacturers of Listed
Chemicals
FORMS: NONE
OMB NO: 1117-0031 EXPIRATION DATE: 01/31/2005
RESPS:3,200 HOURS:1,600 COSTS(000):$0
Application for Registration Under Domestic Chemical Diversion
Control Act of 1993 and Renewal Application for Registration
under Domestic Chemical Diversion Control Act of 1993
FORMS: FORM-510 FORM-510A
OMB NO: 1117-0033 EXPIRATION DATE: 09/30/2003
RESPS:1,200 HOURS:1,200 COSTS(000):$0
Report of Mail Order Transactions
FORMS: NONE
OMB NO: 1117-0034 EXPIRATION DATE: 09/30/2003
RESPS:1,200 HOURS:1,200 COSTS(000):$0
Collection of Laboratory Analysis Data on Drug Samples Testes by
Non-Federal (State and Local Government) Crime Laboratories
FORMS: NONE
OMB NO: 1117-0037 EXPIRATION DATE: 01/31/2006
RESPS:25 HOURS:125 COSTS(000):$0
Prescription Monitoring Program Questionnaire
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
20 1,154,430 360,211 $97,474
Office of Justice Programs
OMB NO: 1121-0021 EXPIRATION DATE: 10/31/2003
RESPS:100 HOURS:400 COSTS(000):$0
Accounting System and Financial Capability Questionnaire
FORMS: 7120/1
OMB NO: 1121-0030 EXPIRATION DATE: 03/31/2004
RESPS:3,796 HOURS:1,885 COSTS(000):$0
Capital Punishment report of inmates under sentence of death
FORMS: NPS-8 NPS-8A NPS-8B NPS-8C
OMB NO: 1121-0064 EXPIRATION DATE: 06/30/2005
RESPS:537 HOURS:656 COSTS(000):$0
Annual Parole Survey, Annual Probation Survey, and Annual
Probation Survey (Short Form)
FORMS: CJ-7 CJ-8 CJ-8A
OMB NO: 1121-0065 EXPIRATION DATE: 06/30/2003
RESPS:2 HOURS:2,196 COSTS(000):$0
National Corrections Reporting Program
FORMS: NCRP-1A NCRP-1B NCRP-1C NCRP-1D
OMB NO: 1121-0078 EXPIRATION DATE: 05/31/2005
RESPS:52 HOURS:338 COSTS(000):$0
Summary of Sentenced Population Movement
FORMS: NPS-1
OMB NO: 1121-0094 EXPIRATION DATE: 05/31/2005
RESPS:946 HOURS:1,183 COSTS(000):$0
Annual Survey of Jails
FORMS: CJ-5 CJ-5A CJ-5B
OMB NO: 1121-0098 EXPIRATION DATE: 09/30/2004
RESPS:8,420 HOURS:7,730 COSTS(000):$0
Survey of Inmates in Local Jails, 2001
FORMS: SIJ-43(X) SIJ-50(X)
OMB NO: 1121-0102 EXPIRATION DATE: 12/31/2004
RESPS:104 HOURS:156 COSTS(000):$0
National Prisoner Statistics-Prison Population Reports NPS-1A:
Midyear Population Counts NPS-1B: Advance Endyear Population
Counts
FORMS: NPS-1A NPS-1B
OMB NO: 1121-0111 EXPIRATION DATE: 10/31/2003
RESPS:270,000 HOURS:80,477 COSTS(000):$0
National Crime Victimization Survey (NCVS)
FORMS: NCVS-1-1A-2-7 NCVS-500-110 572(L)-573(L) 593(L)-594(L) 541-545
1SP-2SP 554-554SP 572(L)SP/KOR/
OMB NO: 1121-0114 EXPIRATION DATE: 10/31/2004
RESPS:53 HOURS:106 COSTS(000):$0
Victims of Crime Act, Victim Compensation Grant Program, State
Performance Report
FORMS: FORM-7390/6
OMB NO: 1121-0130 EXPIRATION DATE: 04/30/2005
RESPS:445,000 HOURS:2,778 COSTS(000):$0
National Judicial Reporting Program (NJRP)
FORMS: NJRP-1
OMB NO: 1121-0137 EXPIRATION DATE: 05/31/2005
RESPS:70,000 HOURS:43,750 COSTS(000):$0
Firearms Addendum to the Arrestee Drug Abuse Monitoring Program
(ADAM)
FORMS: AD-1
OMB NO: 1121-0140 EXPIRATION DATE: 01/31/2006
RESPS:8,250 HOURS:3,000 COSTS(000):$0
Equal Employment Opportunity Plan Short Form and Certification,
28 CFR Section 42.301 et seq.
FORMS: NONE
OMB NO: 1121-0142 EXPIRATION DATE: 10/31/2003
RESPS:5,900 HOURS:295 COSTS(000):$0
Victims of Crime Act, Crime Victim Assistance Grant Program,
Subgrant Award Report
FORMS: 7390/2A
OMB NO: 1121-0147 EXPIRATION DATE: 04/30/2003
RESPS:1,750 HOURS:5,250 COSTS(000):$0
2000 Census of State and Federal Adult Correctional Facilities
FORMS: CJ-43
OMB NO: 1121-0149 EXPIRATION DATE: 03/31/2004
RESPS:2,400 HOURS:850 COSTS(000):$0
2000 National Survey of Prosecutors
FORMS: NSP-5L NSP-5S
OMB NO: 1121-0152 EXPIRATION DATE: 10/31/2005
RESPS:20,435 HOURS:25,345 COSTS(000):$0
Survey of Inmates in State and Federal Correctional Facilities,
2003
FORMS: NPS-25 NPS-26 NPS-27 NPS-13
OMB NO: 1121-0170 EXPIRATION DATE: 12/31/2005
RESPS:54 HOURS:54 COSTS(000):$0
Crime Victim Compensation State Certification Form
FORMS: 7390/5
OMB NO: 1121-0184 EXPIRATION DATE: 05/31/2004
RESPS:12,200 HOURS:2,038 COSTS(000):$0
School Crime Supplement (SCS)
FORMS: SCS-1
OMB NO: 1121-0188 EXPIRATION DATE: 10/31/2003
RESPS:2,500 HOURS:10,000 COSTS(000):$0
Budget Detail Worksheet
FORMS: NONE
OMB NO: 1121-0189 EXPIRATION DATE: 04/30/2005
RESPS:20 HOURS:60 COSTS(000):$0
Nomination for Young American Medal for Bravery
FORMS: 1673/1
OMB NO: 1121-0190 EXPIRATION DATE: 04/30/2005
RESPS:20 HOURS:60 COSTS(000):$0
Nomination for Young American Medal for Service
FORMS: 1673/2
OMB NO: 1121-0196 EXPIRATION DATE: 05/31/2003
RESPS:1 HOURS:3,500 COSTS(000):$0
Local Law Enforcement Block Grants Program Application
FORMS: NONE
OMB NO: 1121-0204 EXPIRATION DATE: 04/30/2004
RESPS:1 HOURS:3,500 COSTS(000):$0
Local Law Enforcement Block Grants Program
FORMS: NONE
OMB NO: 1121-0218 EXPIRATION DATE: 07/31/2004
RESPS:1 HOURS:10,675 COSTS(000):$0
Census of Juveniles in Residential Placement
FORMS: CJ-14
OMB NO: 1121-0219 EXPIRATION DATE: 03/31/2004
RESPS:1 HOURS:7,000 COSTS(000):$0
Juvenile Residential Facility Census
FORMS: CJ-15
OMB NO: 1121-0223 EXPIRATION DATE: 02/29/2004
RESPS:2,798 HOURS:562 COSTS(000):$0
Crime Mapping Survey
FORMS: NONE
OMB NO: 1121-0224 EXPIRATION DATE: 04/30/2005
RESPS:2,565 HOURS:641 COSTS(000):$0
National Youth Gang Survey
FORMS: NONE
OMB NO: 1121-0233 EXPIRATION DATE: 07/31/2003
RESPS:125 HOURS:62 COSTS(000):$0
Certification of Compliance with Eligibility Requirements of
Sec. 826 of the Higher Education Amendments of 1998
FORMS: NONE
OMB NO: 1121-0234 EXPIRATION DATE: 04/30/2003
RESPS:4,200 HOURS:4,200 COSTS(000):$0
Requirements: Data Collection Application for the Juvenile
Accountability Incentive Block Grant Program
FORMS: NONE
OMB NO: 1121-0235 EXPIRATION DATE: 04/30/2003
RESPS:3 HOURS:125,000 COSTS(000):$0
Bulletproof Vest Partnership
FORMS: NONE
OMB NO: 1121-0237 EXPIRATION DATE: 06/30/2003
RESPS:7,000 HOURS:1,650 COSTS(000):$0
Generic Clearance of Customer Satisfaction Surveys
FORMS: NCJ-CR-01-001 NCJ-CR-01-002 NCJ-CR-01-003 NCJ-CR-01-004
NCJ-CR-01-005 NCJ-CR-01-006
OMB NO: 1121-0238 EXPIRATION DATE: 07/31/2003
RESPS:10,780 HOURS:7,875 COSTS(000):$0
Survey of Youth in Residential Placement
FORMS: NONE
OMB NO: 1121-0240 EXPIRATION DATE: 05/31/2003
RESPS:19,000 HOURS:14,000 COSTS(000):$0
2000 Census of State and Local Law Enforcement Agencies
FORMS: CJ-38L CJ-38S
OMB NO: 1121-0242 EXPIRATION DATE: 06/30/2004
RESPS:250 HOURS:375 COSTS(000):$0
Comprehensive Strategy Stakeholder Survey
FORMS: NONE
OMB NO: 1121-0243 EXPIRATION DATE: 02/29/2004
RESPS:3,000 HOURS:12,000 COSTS(000):$0
Grants Management System Online Application
FORMS: NONE
OMB NO: 1121-0245 EXPIRATION DATE: 05/31/2004
RESPS:550 HOURS:416,150 COSTS(000):$23,045
Program Guidance on Environmental Protection Requirements and
Project Status Report
FORMS: N/A
OMB NO: 1121-0246 EXPIRATION DATE: 08/31/2004
RESPS:1,070 HOURS:450 COSTS(000):$0
National Business Survey on White Collar Crime
FORMS: NONE
OMB NO: 1121-0247 EXPIRATION DATE: 10/31/2004
RESPS:19,426 HOURS:17,796 COSTS(000):$0
National Evaluation of the Safe Schools/Healthy Students
Initiative
FORMS: NONE
OMB NO: 1121-0249 EXPIRATION DATE: 09/30/2004
RESPS:16,067 HOURS:3,802 COSTS(000):$0
Deaths in Custody, 2001--series of collections on local jail
jurisdictions, State prisons, and State juvenile facilities
FORMS: NPS-4 NPS-4A NPS-5 NPS-5A CJ-9 CJ-9A CJ-10 CJ-10A
OMB NO: 1121-0250 EXPIRATION DATE: 12/31/2004
RESPS:1,000 HOURS:4,000 COSTS(000):$0
Community Gun Violence Prosecution Program
FORMS: NONE
OMB NO: 1121-0251 EXPIRATION DATE: 09/30/2004
RESPS:300 HOURS:187 COSTS(000):$0
Victimization of People With Disabilities
FORMS: CDER-1A CDER-1B CDER-2A CDER-2B
OMB NO: 1121-0252 EXPIRATION DATE: 12/31/2004
RESPS:556 HOURS:185 COSTS(000):$0
2001 Census of Tribal Justice Agencies
FORMS: CTJA01
OMB NO: 1121-0253 EXPIRATION DATE: 09/30/2004
RESPS:20,732 HOURS:41,464 COSTS(000):$0
Categorical Assistance Progress Report
FORMS: 4587/1
OMB NO: 1121-0255 EXPIRATION DATE: 04/30/2005
RESPS:800 HOURS:1,200 COSTS(000):$0
2002 Census of Law Enforcement Training Academies
FORMS: CJ-52
OMB NO: 1121-0258 EXPIRATION DATE: 10/31/2003
RESPS:45 HOURS:45 COSTS(000):$0
Data Collection from Grantees from the Grants to Reduce Violent
Crimes on Campus Program
FORMS: NONE
OMB NO: 1121-0259 EXPIRATION DATE: 12/31/2005
RESPS:500 HOURS:500 COSTS(000):$0
Public Safety Officer Medal of Valor Application
FORMS: 1121
OMB NO: 1121-0260 EXPIRATION DATE: 06/30/2003
RESPS:84,700 HOURS:5,065 COSTS(000):$0
Police Public Contact Survey
FORMS: PPCS-1
OMB NO: 1121-0261 EXPIRATION DATE: 09/30/2005
RESPS:21,390 HOURS:5,347 COSTS(000):$0
Domestic Preparedness Training Evaluation and Follow-up
FORMS: NONE
OMB NO: 1121-0264 EXPIRATION DATE: 01/31/2006
RESPS:81,284 HOURS:67,752 COSTS(000):$0
Financial Status Report (Short Form)
FORMS: NONE
OMB NO: 1121-0265 EXPIRATION DATE: 05/31/2003
RESPS:250 HOURS:125 COSTS(000):$0
Survey of Practitioners to Assess the Impact of Transnational
Crime
FORMS: NONE
OMB NO: 1121-0266 EXPIRATION DATE: 01/31/2006
RESPS:290 HOURS:2,320 COSTS(000):$0
NITAC User Feedback Form
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
52 1,151,224 946,035 $23,045
Executive Office for Immigration Review
OMB NO: 1125-0001 EXPIRATION DATE: 08/31/2005
RESPS:11,000 HOURS:63,250 COSTS(000):$1,100
Application for Cancellation of Removal: 42A) for Certain
Permanent Residents, and 42B) Adjustment of Status for Certain
Nonpermanent Residents
FORMS: EOIR-42A 42B
OMB NO: 1125-0002 EXPIRATION DATE: 12/31/2005
RESPS:23,417 HOURS:11,708 COSTS(000):$2,576
Notice of Appeal From a Decision of an Immigration Judge
FORMS: EOIR-26
OMB NO: 1125-0003 EXPIRATION DATE: 09/30/2005
RESPS:1,500 HOURS:1,500 COSTS(000):$0
Fee Waiver Request
FORMS: EOIR-26A
OMB NO: 1125-0004 EXPIRATION DATE: 08/31/2005
RESPS:15,000 HOURS:750 COSTS(000):$0
Alien's Change of Address Form (formerly) Change of Address Form
FORMS: EOIR-33/IC EOIR-33/BIA
OMB NO: 1125-0005 EXPIRATION DATE: 02/28/2006
RESPS:26,000 HOURS:2,600 COSTS(000):$130
Notice of Entry of Appearance as Attorney or Representative
Before the Board of Immigration Appeals
FORMS: EOIR-27
OMB NO: 1125-0006 EXPIRATION DATE: 02/28/2006
RESPS:77,000 HOURS:7,700 COSTS(000):$385
Notice of Entry of Appearance as Attorney or Representative
Before the Immigration Court
FORMS: EOIR-28
OMB NO: 1125-0007 EXPIRATION DATE: 02/28/2006
RESPS:500 HOURS:1,000 COSTS(000):$0
Immigration Practitioner Complaint Form
FORMS: EOIR-44
OMB NO: 1125-0008 EXPIRATION DATE: 02/28/2006
RESPS:50 HOURS:50 COSTS(000):$0
Notice of Appeal to the Board of Immigration Appeals of Decision
of Adjudicating Official in Practitioner Disciplinary Case
FORMS: EOIR-45
OMB NO: 1125-0009 EXPIRATION DATE: 03/31/2006
RESPS:2,000 HOURS:11,500 COSTS(000):$200
Application for Suspension of Deportation
FORMS: EOIR-40
OMB NO: 1125-0010 EXPIRATION DATE: 01/31/2006
RESPS:3,156 HOURS:1,578 COSTS(000):$347
Notice of Appeal to the Board of Immigration Appeals From a
Decision of an INS Officer
FORMS: EOIR-29
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
10 159,623 101,636 $4,738
Bureau of Alcohol, Tobacco, Firearms and Explosives
OMB NO: 1140-0001 EXPIRATION DATE: 07/31/2003
RESPS:21,000 HOURS:168 COSTS(000):$0
ATF Distribution Center Contractor Survey
FORMS: ATF-F-1600.7
OMB NO: 1140-0002 EXPIRATION DATE: 07/31/2003
RESPS:250 HOURS:125 COSTS(000):$0
Application for Restoration of Firearms Privileges
FORMS: ATF-F-3210.1
OMB NO: 1140-0003 EXPIRATION DATE: 08/31/2003
RESPS:40,000 HOURS:8,000 COSTS(000):$0
Report of Multiple Sales or Other Disposition of Pistols and
Revolvers
FORMS: ATF-F-3310.4
OMB NO: 1140-0004 EXPIRATION DATE: 08/31/2004
RESPS:338 HOURS:338 COSTS(000):$0
Interstate Firearms Shipment Report of Theft/Loss
FORMS: ATF-FORM-3310.6
OMB NO: 1140-0005 EXPIRATION DATE: 07/31/2005
RESPS:11,000 HOURS:5,500 COSTS(000):$0
Application and Permit for Importation of Firearms, Ammunition
and Implements of War
FORMS: 6(5330.3A)PT.I
OMB NO: 1140-0006 EXPIRATION DATE: 09/30/2003
RESPS:9,000 HOURS:4,500 COSTS(000):$0
Application and Permit for Importation of Firearms, Ammunition
and Implements of War
FORMS: ATF-FORM-6 PARTII(5330.3B)
OMB NO: 1140-0007 EXPIRATION DATE: 12/31/2003
RESPS:20,000 HOURS:8,000 COSTS(000):$0
Release and Receipt of Imported firearms, Ammunition and
Implements of War
FORMS: ATF-FORM-6A (5330.3C)
OMB NO: 1140-0008 EXPIRATION DATE: 07/31/2003
RESPS:350 HOURS:1,050 COSTS(000):$0
Application and Permit for Permanent Exportation of Firearms
FORMS: FORM-9(5320.9)
OMB NO: 1140-0009 EXPIRATION DATE: 01/31/2004
RESPS:300 HOURS:150 COSTS(000):$0
Application to Register as an Importer of U.S. Munitions Import
List Articles
FORMS: ATF-F-4587 (5330.4)
OMB NO: 1140-0010 EXPIRATION DATE: 07/31/2003
RESPS:800 HOURS:400 COSTS(000):$0
Application to Transport Interstate or Temporarily Export
Certain National Firearms Act (NFA) Firearms
FORMS: FORM-5320.20
OMB NO: 1140-0011 EXPIRATION DATE: 02/29/2004
RESPS:1,071 HOURS:4,271 COSTS(000):$0
Application to Make and Register a Firearm
FORMS: ATF1(5320.1)
OMB NO: 1140-0012 EXPIRATION DATE: 05/31/2004
RESPS:5,000 HOURS:3,750 COSTS(000):$0
Notice of Firearms Manufactured or Imported
FORMS: ATF-F-2(5320.2)
OMB NO: 1140-0013 EXPIRATION DATE: 07/31/2004
RESPS:26,221 HOURS:13,111 COSTS(000):$0
Application for Tax Exempt Transfer of Firearm and Registration
to Special (Occupational) Taxpayer
FORMS: FORM-3(5320.3)
OMB NO: 1140-0014 EXPIRATION DATE: 08/31/2004
RESPS:11,065 HOURS:44,260 COSTS(000):$0
Application for Tax Paid Transfer and Registration of Firearm
FORMS: FORM-4(5320.4)
OMB NO: 1140-0015 EXPIRATION DATE: 08/31/2004
RESPS:94,974 HOURS:379,896 COSTS(000):$0
Application for Tax Exempt Transfer and Registration of Firearm
FORMS: FORM5(5320.5)
OMB NO: 1140-0016 EXPIRATION DATE: 01/31/2005
RESPS:1,200 HOURS:300 COSTS(000):$0
Application for Registration of Firearms Acquired by Certain
Governmental Entities
FORMS: FORM-10(5320.10
OMB NO: 1140-0017 EXPIRATION DATE: 07/31/2003
RESPS:1,500 HOURS:1,125 COSTS(000):$0
Annual Firearms Manufacturing and Exportation Report
FORMS: ATF-F-5300.11
OMB NO: 1140-0018 EXPIRATION DATE: 02/29/2004
RESPS:10,000 HOURS:12,500 COSTS(000):$0
Application for License under 18 U.S.C. Chapter 44, Firearms
FORMS: ATF7(5310.12)
OMB NO: 1140-0019 EXPIRATION DATE: 08/31/2004
RESPS:35,000 HOURS:14,700 COSTS(000):$0
Application for Renewal of Federal Firearms License
FORMS: ATF-F-8 5310.11PARTII
OMB NO: 1140-0020 EXPIRATION DATE: 06/30/2005
RESPS:10,225,000 HOURS:3,408,333 COSTS(000):$0
Firearms Transaction Record, Part 1, Over-the-Counter
FORMS: ATF-F-4473 (5300.9)PT.1
OMB NO: 1140-0021 EXPIRATION DATE: 04/30/2005
RESPS:20,900 HOURS:9,057 COSTS(000):$0
Firearms Transaction Record, Part II Non-Over-The-Counter
FORMS: 4473(5300.9) PARTII
OMB NO: 1140-0022 EXPIRATION DATE: 07/31/2003
RESPS:2,500 HOURS:825 COSTS(000):$0
Renewal of Explosives License or Permit
FORMS: 5400.14 5400.15 PART-III
OMB NO: 1140-0023 EXPIRATION DATE: 05/31/2003
RESPS:25,000 HOURS:7,500 COSTS(000):$0
Explosives Delivery Record
FORMS: 5400.8
OMB NO: 1140-0024 EXPIRATION DATE: 08/31/2005
RESPS:1 HOURS:250 COSTS(000):$0
Report of Firearms Transactions, ATF F 4483 (5300.35)
FORMS: 4483(5300.35)
OMB NO: 1140-0025 EXPIRATION DATE: 05/31/2003
RESPS:22,800 HOURS:7,227 COSTS(000):$0
Explosives transaction Record
FORMS: 5400.4
OMB NO: 1140-0026 EXPIRATION DATE: 11/30/2005
RESPS:150 HOURS:270 COSTS(000):$0
Report of Theft or Loss of Explosives
FORMS: 5400.5
OMB NO: 1140-0027 EXPIRATION DATE: 08/31/2004
RESPS:1,092 HOURS:22 COSTS(000):$0
User-limited (Explosives) ATF F 5400.6
FORMS: ATF-FORM-5400.6
OMB NO: 1140-0028 EXPIRATION DATE: 08/31/2004
RESPS:26,212 HOURS:26,212 COSTS(000):$0
Inventories, Licensed Explosives Importers, Manufacturers,
Dealers, and Permittees
FORMS: ATF-REC-5400/1
OMB NO: 1140-0029 EXPIRATION DATE: 10/31/2005
RESPS:68,335 HOURS:68,835 COSTS(000):$0
Records and Supporting Data: Daily Summaries, Records of
Production, Storage, and Disposition, and Suppporting Data by
Licensed Explosives Manufacturers and Manufacturers (Limited)
FORMS: ATF-REC-5004/2
OMB NO: 1140-0030 EXPIRATION DATE: 12/31/2004
RESPS:637,570 HOURS:637,570 COSTS(000):$0
RECORDS AND SUPPORTING DATA: Importation, Receipt, Storage, and
Disposition by Licensed Explosives Manufacturers, Importers,
Dealers, and Users
FORMS: ATF-REC-5400/A
OMB NO: 1140-0031 EXPIRATION DATE: 08/31/2005
RESPS:5 HOURS:250 COSTS(000):$0
Records of Acquisition and Dispositon - Registered Importers of
Arms, Ammunition and Implements of War on the U.S. Munitions
imports List ATF REC 7570/1
FORMS: ATF-REC-7570/1
OMB NO: 1140-0032 EXPIRATION DATE: 02/29/2004
RESPS:172,250 HOURS:559,791 COSTS(000):$0
Records of Acquisition and Disposition, Collectors of Firearms
FORMS: 7570/2 7570/3
OMB NO: 1140-0033 EXPIRATION DATE: 04/30/2004
RESPS:3,000 HOURS:1,500 COSTS(000):$0
Request for Disposition of Offense
FORMS: FORM-5020.29
OMB NO: 1140-0034 EXPIRATION DATE: 01/31/2006
RESPS:1,800 HOURS:540 COSTS(000):$4
Application Permit For User Limited Special Fireworks (18 U.S.C.
Chapter 40, Explosives)
FORMS: 5400.21
OMB NO: 1140-0035 EXPIRATION DATE: 04/30/2005
RESPS:5,000 HOURS:1,042 COSTS(000):$0
Firearms Transaction Record Part I--Low Volume-Over-the-Counter
Firearms Transaction Record Part II--Low Volume-Intra-State Non-
Over-the-Counter ATF REC 7570/2
FORMS: ATF-F-4473 (5300.24)PT-I ATF-F-4473 (5300.25)PT-II ATF-REC7570/2
OMB NO: 1140-0036 EXPIRATION DATE: 11/30/2005
RESPS:28,000 HOURS:2,380 COSTS(000):$9,000
Letterhead Request for Information in Regard to Federal Firearms
Dealer's Records (Dealer's Records of Acquisition, Disposition &
Supporting Data)
FORMS: 5300.3
OMB NO: 1140-0037 EXPIRATION DATE: 02/29/2004
RESPS:5 HOURS:3 COSTS(000):$0
Letter Application to Obtain Authorization for the Assembly of a
Nonsporting Rifle or Nonsporting Shotgun for the Purpose of
Testing and Evaluation
FORMS: NONE
OMB NO: 1140-0038 EXPIRATION DATE: 05/31/2004
RESPS:6,000 HOURS:1,500 COSTS(000):$0
Application for License, Collector of Curios and Relics
FORMS: ATF-F-7CR 5310.16
OMB NO: 1140-0039 EXPIRATION DATE: 05/31/2003
RESPS:4,000 HOURS:1,600 COSTS(000):$0
Federal Firearms Licensee Theft/Loss Report ATF F 3310.11
FORMS: ATF-F-3310.11
OMB NO: 1140-0040 EXPIRATION DATE: 07/31/2004
RESPS:18,000 HOURS:22,500 COSTS(000):$0
ATF F 5300.38, Application for an Amended Federal Firearms
License
FORMS: ATF-F-5300.38
OMB NO: 1140-0041 EXPIRATION DATE: 07/31/2004
RESPS:2,107,000 HOURS:458,942 COSTS(000):$0
Implementation of Public Law 103-322, The Violent Crime Control
and Law Enforcement Act of 1994
FORMS: NONE
OMB NO: 1140-0042 EXPIRATION DATE: 01/31/2004
RESPS:32 HOURS:16 COSTS(000):$0
Statement of Process-Marking of Plastic Explosives for the
Purpose of Detection
FORMS: NONE
OMB NO: 1140-0043 EXPIRATION DATE: 09/30/2003
RESPS:183,933 HOURS:198,015 COSTS(000):$0
National Tracing Center Trace Request and NTC Obliterated Serial
Number Trace Request
FORMS: ATF-F-3312.1 ATF-F-3312.2
OMB NO: 1140-0044 EXPIRATION DATE: 12/31/2004
RESPS:1,556 HOURS:156 COSTS(000):$0
Annual Firearms Manufacturing and Exportation Report of
Semiautomatic Assault Weapons
FORMS: ATF-F-5300.11A
OMB NO: 1140-0045 EXPIRATION DATE: 08/31/2004
RESPS:9,248,000 HOURS:1 COSTS(000):$0
Implementation of Public Law 103-159, Relating to the Permanent
Provisions of the Brady Handgun Violence Prevention Act. "FINAL
RULE"
FORMS: NONE
OMB NO: 1140-0046 EXPIRATION DATE: 02/28/2005
RESPS:50,000 HOURS:389 COSTS(000):$0
Certification on Agency Letterhead Authorizing Purchase of
Firearm for Official Duties of Law Enforcement Officer
FORMS: NONE
OMB NO: 1140-0047 EXPIRATION DATE: 11/30/2004
RESPS:10,000 HOURS:500 COSTS(000):$0
Race and National Origin Identification
FORMS: ATF-F-2931.1
OMB NO: 1140-0048 EXPIRATION DATE: 05/31/2005
RESPS:400 HOURS:800 COSTS(000):$0
Gang Resistance Education and Training Funding Application
FORMS: ATF-F-6410.1
OMB NO: 1140-0049 EXPIRATION DATE: 11/30/2005
RESPS:75 HOURS:13 COSTS(000):$0
Application for National Firearm Examiner Academy
FORMS: 6330.1
OMB NO: 1140-0050 EXPIRATION DATE: 10/31/2005
RESPS:2,506 HOURS:5,665 COSTS(000):$0
Notice of Proposed Rulemaking Identification Markings Placed on
Firearms 27 CFR 178.92 and 179.102
FORMS: NONE
OMB NO: 1140-0051 EXPIRATION DATE: 01/31/2006
RESPS:31,000 HOURS:600 COSTS(000):$0
Certification of Secure Gun Storage or Safety Devices
FORMS: 5300.42
OMB NO: 1140-0052 EXPIRATION DATE: 05/31/2003
RESPS:1,500 HOURS:450 COSTS(000):$0
Strategic Planning Environmental Assessment Outreach
FORMS: NONE
OMB NO: 1140-0053 EXPIRATION DATE: 10/31/2003
RESPS:500 HOURS:50 COSTS(000):$0
State and Local Training Registration Request
FORMS: 6400.1
OMB NO: 1140-0054 EXPIRATION DATE: 10/31/2003
RESPS:929,000 HOURS:15,483 COSTS(000):$0
Notice of Proposed Rulemaking Commerce in Firearms and
Ammunition - Annual Inventory of Firearms
FORMS: NONE
OMB NO: 1140-0055 EXPIRATION DATE: 05/31/2004
RESPS:1,563 HOURS:1 COSTS(000):$0
Identification of Explosive Materials
FORMS: NONE
OMB NO: 1140-0056 EXPIRATION DATE: 05/31/2004
RESPS:300 HOURS:225 COSTS(000):$0
Special Agent Medical Preplacement
FORMS: ATF-F-2300.10
OMB NO: 1140-0057 EXPIRATION DATE: 01/31/2005
RESPS:100 HOURS:17 COSTS(000):$0
Notice of proposed rulemaking: A National Repository for the
collection and inventory of information related to arson and the
criminal misuse of explosives
FORMS: NONE
OMB NO: 1140-0058 EXPIRATION DATE: 10/31/2004
RESPS:2,500 HOURS:250 COSTS(000):$0
Investigator Integrity Questionnaire
FORMS: ATF-F-8620.7
OMB NO: 1140-0059 EXPIRATION DATE: 04/30/2005
RESPS:1,900 HOURS:317 COSTS(000):$646
Search For Artifacts and Memorabilia
FORMS: NONE
OMB NO: 1140-0060 EXPIRATION DATE: 08/31/2005
RESPS:12,100 HOURS:1,210 COSTS(000):$0
Implementation of Public Law 105-277, Omnibus Consolidated and
Emergency Appropriations Act, 1999, Related to Firearms
Disabilities for Nonimmigrant Aliens
FORMS: NONE
OMB NO: 1140-0061 EXPIRATION DATE: 11/30/2005
RESPS:3,000 HOURS:150 COSTS(000):$0
Certificate of Compliance with 18 USC 922(g)(5)(B)
FORMS: 5330.20
OMB NO: 1140-0062 EXPIRATION DATE: 11/30/2005
RESPS:45 HOURS:45 COSTS(000):$0
Identification of Imported Explosives Materials (NPRM)
FORMS: NONE
OMB NO: 1140-0063 EXPIRATION DATE: 11/30/2005
RESPS:125 HOURS:63 COSTS(000):$0
Evaluation of Training Arson For Prosecutors (follow-up survey)
Training Program
FORMS: NONE
OMB NO: 1140-0064 EXPIRATION DATE: 05/31/2003
RESPS:150 HOURS:75 COSTS(000):$0
Application for Restoration of Explosives Privileges
FORMS: 5400.29
OMB NO: 1140-0065 EXPIRATION DATE: 08/31/2003
RESPS:30,000 HOURS:1,725 COSTS(000):$10,000
Requisition For Forms or Publications - ATF F 1370.3 Requisition
For Firearms Explosives Forms - ATF F 1370.2
FORMS: 1370.3 1370.2
OMB NO: 1140-0066 EXPIRATION DATE: 07/31/2003
RESPS:325 HOURS:325 COSTS(000):$0
Manufacturers of Ammunition, Records and Supporting Data of
Ammunition Manufactured and Disposed of
FORMS: ATF-REC-5000/2
OMB NO: 1140-0067 EXPIRATION DATE: 08/31/2005
RESPS:4,304,000 HOURS:76,611 COSTS(000):$0
Licensed Firearms Manufacturers Records of Production,
Disposition, and Supporting Data
FORMS: 5300/1
OMB NO: 1140-0068 EXPIRATION DATE: 01/31/2005
RESPS:1,000 HOURS:83 COSTS(000):$0
Personnel Security Request
FORMS: FORM-8620.5
OMB NO: 1140-0069 EXPIRATION DATE: 04/30/2005
RESPS:5,500 HOURS:2,750 COSTS(000):$0
Computer Security Incident Report
FORMS: ATF-F-7500.1
OMB NO: 1140-0070 EXPIRATION DATE: 08/31/2003
RESPS:1,000 HOURS:15,000 COSTS(000):$741,300
Application for Explosives License or Permit
FORMS: 5400.13 5400.16
OMB NO: 1140-0071 EXPIRATION DATE: 03/31/2006
RESPS:20,014 HOURS:60,342 COSTS(000):$0
Notification to Fire Marshal and Chief, Law Enforcement Officer
of Storage of Explosive Material
FORMS: NONE
OMB NO: 1140-0072 EXPIRATION DATE: 08/31/2003
RESPS:10,000 HOURS:3,334 COSTS(000):$0
Employee Possessor Questionnaire
FORMS: ATF-F-5400.28
OMB NO: 1140-0073 EXPIRATION DATE: 08/31/2003
RESPS:2,350 HOURS:1,175 COSTS(000):$47
Furnishing of samples
FORMS: NONE
OMB NO: 1140-0074 EXPIRATION DATE: 08/31/2003
RESPS:100,000 HOURS:100,000 COSTS(000):$0
List of Responsible Persons
FORMS: NONE
OMB NO: 1140-0075 EXPIRATION DATE: 08/31/2003
RESPS:50,000 HOURS:25,000 COSTS(000):$0
Transactions among licensees/permittees, Limited
FORMS: NONE
OMB NO: 1140-0076 EXPIRATION DATE: 08/31/2003
RESPS:50 HOURS:1 COSTS(000):$0
Relief of Disabilities
FORMS: NONE
OMB NO: 1140-0077 EXPIRATION DATE: 08/31/2003
RESPS:800 HOURS:264 COSTS(000):$0
Report of Stolen or Lost ATEE Forms 5400.30, Intrastate Purchase
Explosive Coupon
FORMS: NONE
OMB NO: 1140-0078 EXPIRATION DATE: 08/31/2003
RESPS:1,500,000 HOURS:12,000 COSTS(000):$0
Limited Permittee Transaction Report
FORMS: NONE
OMB NO: 1140-0079 EXPIRATION DATE: 08/31/2003
RESPS:50,000 HOURS:25,000 COSTS(000):$0
Transactions among licensee/permittees and transactions among
licensees and holders of used permits.
FORMS: NONE
OMB NO: 1140-0080 EXPIRATION DATE: 08/31/2003
RESPS:1,000 HOURS:170 COSTS(000):$0
Notification of Change of Mailing or Premise Address
FORMS: NONE
OMB NO: 1140-0081 EXPIRATION DATE: 08/31/2003
RESPS:500 HOURS:1,000 COSTS(000):$0
Appeals of Background Checks
FORMS: NONE
OMB NO: 1140-0082 EXPIRATION DATE: 08/31/2003
RESPS:50,000 HOURS:416 COSTS(000):$0
Certificate of Knowledge of State Laws, Submission of Water
Pollution Act
FORMS: NONE
OMB NO: 1140-0083 EXPIRATION DATE: 08/31/2003
RESPS:24,000 HOURS:2,000 COSTS(000):$0
Application for Limited Permit
FORMS: NONE
OMB NO: 1140-0084 EXPIRATION DATE: 06/30/2003
RESPS:15,000 HOURS:7,500 COSTS(000):$0
Application and Permit for Temporary Importation of Firearms and
Ammunition by Nonimmigrant Aliens
FORMS: 6NIA
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
84 30,309,513 6,277,480 $760,997
Civil Rights Division
OMB NO: 1190-0001 EXPIRATION DATE: 11/30/2005
RESPS:4,873 HOURS:48,730 COSTS(000):$0
Procedures for the Administration of Section 5 of the Voting
Rights Act of 1965
FORMS: NONE
OMB NO: 1190-0004 EXPIRATION DATE: 02/29/2004
RESPS:6,000 HOURS:48,000 COSTS(000):$0
Nondiscrimination on the Basis of Disability in State and Local
Government Services
FORMS: NONE
OMB NO: 1190-0005 EXPIRATION DATE: 02/29/2004
RESPS:10 HOURS:320 COSTS(000):$0
Nondiscrimination on the Basis of Disability in State and Local
Government Services (Certification).
FORMS: NONE
OMB NO: 1190-0006 EXPIRATION DATE: 02/29/2004
RESPS:15,000 HOURS:90,000 COSTS(000):$0
Nondiscrimination on the Basis of Disability in State and Local
Government Services (Self-Evaluation).
FORMS: NONE
OMB NO: 1190-0008 EXPIRATION DATE: 02/29/2004
RESPS:1,560 HOURS:780 COSTS(000):$0
Complaint Form, Coordination and Review Section, Civil Rights
Division, Department of Justice
FORMS: NONE
OMB NO: 1190-0009 EXPIRATION DATE: 02/29/2004
RESPS:5,000 HOURS:3,750 COSTS(000):$0
Title II of the Americans with Disabilities Act of 1990/Section
504 of the Rehabilitation Act of 1973 Discrimination Complaint
Form.
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
6 32,443 191,580 $0
AGENCY TOTALS:
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
241 36,402,097 12,204,024 $891,063
Department of Labor
Employment and Training Administration
OMB NO: 1205-0001 EXPIRATION DATE: 02/29/2004
RESPS:416 HOURS:416 COSTS(000):$0
Work Application/Job Order Recordkeeping
FORMS: N/A
OMB NO: 1205-0009 EXPIRATION DATE: 04/30/2003
RESPS:12 HOURS:5,512 COSTS(000):$0
Distribution of Characteristics of the Insured Unemployed
FORMS: ETA-203
OMB NO: 1205-0010 EXPIRATION DATE: 04/30/2003
RESPS:714 HOURS:1,359 COSTS(000):$0
Claims and Payment Activities
FORMS: ETA-5159
OMB NO: 1205-0015 EXPIRATION DATE: 08/31/2003
RESPS:73,500 HOURS:196,000 COSTS(000):$0
Application for Alien employment certification
FORMS: ETA-750-PART-A ETA-750-PART-B
OMB NO: 1205-0016 EXPIRATION DATE: 04/30/2003
RESPS:17,100 HOURS:3,420 COSTS(000):$0
Quarterly Determinations, Allowance Activities, and
Employability Services under the Trade Act
FORMS: ETA-563
OMB NO: 1205-0017 EXPIRATION DATE: 03/31/2004
RESPS:39,405 HOURS:16,301 COSTS(000):$0
Domestic Agricultural In-Season Wage Report
FORMS: ETA-232 ETA-232A
OMB NO: 1205-0025 EXPIRATION DATE: 09/30/2003
RESPS:94,792 HOURS:47,781 COSTS(000):$3,060
Job Corps Application Data
FORMS: ETA-652 ETA-655 ETA-682
OMB NO: 1205-0028 EXPIRATION DATE: 07/31/2003
RESPS:5,512 HOURS:3,675 COSTS(000):$0
Weekly Claims and Extended Benefits Data and Weekly Initial and
Continued Weeks Claimed
FORMS: 539 538
OMB NO: 1205-0029 EXPIRATION DATE: 12/31/2004
RESPS:212 HOURS:848 COSTS(000):$0
Interstate Arrangement for Combining Employment and Wages
FORMS: ETA-586
OMB NO: 1205-0030 EXPIRATION DATE: 02/29/2004
RESPS:1 HOURS:1,500 COSTS(000):$0
Job Corps Enrollee Allotment Determination
FORMS: ETA-658
OMB NO: 1205-0033 EXPIRATION DATE: 01/31/2004
RESPS:93,000 HOURS:7,750 COSTS(000):$0
Job Corps Health Questionnaire
FORMS: ETA-6-53
OMB NO: 1205-0035 EXPIRATION DATE: 02/29/2004
RESPS:62,429 HOURS:13,567 COSTS(000):$177
Job Corps Placement and Assistance Record
FORMS: ETA-678
OMB NO: 1205-0039 EXPIRATION DATE: 06/30/2004
RESPS:3,046 HOURS:5,537 COSTS(000):$3
Program Monitoring Report and Job Srvice Complaint Form
FORMS: ETA-8429 ETA-5148
OMB NO: 1205-0040 EXPIRATION DATE: 08/31/2003
RESPS:434 HOURS:1,776 COSTS(000):$0
Senior Community Service Employment Program (SCSEP)
FORMS: ETA-5140 ETA-8705 ETA-5163
OMB NO: 1205-0051 EXPIRATION DATE: 01/31/2005
RESPS:162,795 HOURS:10,177 COSTS(000):$0
Employment and Training Administration (ETA) Disaster
Unemployment Assistance (DUA) Handbook and Operating Forms,
Including ETA 90-2, Disaster Payment Activities Under the....
FORMS: ETA-90-2
OMB NO: 1205-0132 EXPIRATION DATE: 03/31/2005
RESPS:835 HOURS:2,121 COSTS(000):$0
Unemployment Insurance (UI) State Quality Service Plan (SQSP)
FORMS: NONE
OMB NO: 1205-0134 EXPIRATION DATE: 06/30/2004
RESPS:5,000 HOURS:3,500 COSTS(000):$0
Forms for Agricultural Recruitment System of Services to
Migratory Workers and Their Employers; Application for Alien
Certification
FORMS: ETA-790 ETA-795
OMB NO: 1205-0137 EXPIRATION DATE: 10/31/2003
RESPS:95 HOURS:47 COSTS(000):$0
Occupational Code Request
FORMS: ETA-741
OMB NO: 1205-0150 EXPIRATION DATE: 10/31/2004
RESPS:224 HOURS:896 COSTS(000):$0
Non-monetary Determination Activity Report
FORMS: NONE
OMB NO: 1205-0154 EXPIRATION DATE: 03/31/2006
RESPS:3,498 HOURS:1,749 COSTS(000):$0
Unemployment Insurance Trust Fund Activity
FORMS: 8401 8405 8403 8413 8414 2112
OMB NO: 1205-0162 EXPIRATION DATE: 07/31/2003
RESPS:212 HOURS:1,272 COSTS(000):$0
Statement of Expenditures and Adjustments of Federal Funds for
Unemployment Compensation for Federal Employees and
Ex-Servicemembers
FORMS: ETA-191
OMB NO: 1205-0164 EXPIRATION DATE: 01/31/2006
RESPS:53 HOURS:13 COSTS(000):$0
Experience Rating Report
FORMS: ETA-204
OMB NO: 1205-0172 EXPIRATION DATE: 10/31/2004
RESPS:648 HOURS:648 COSTS(000):$0
Benefit Appeals Report
FORMS: ETA-5130
OMB NO: 1205-0173 EXPIRATION DATE: 11/30/2003
RESPS:212 HOURS:2,968 COSTS(000):$0
Overpayment Detection and recovery Activities
FORMS: ETA-227
OMB NO: 1205-0176 EXPIRATION DATE: 04/30/2003
RESPS:66,126 HOURS:1,708 COSTS(000):$1,527
Unemployment Compensation for Ex-Servicemembers (UCX) Handbook
(ETA Handbook No. 384)
FORMS: ETA-841 ETA-843
OMB NO: 1205-0177 EXPIRATION DATE: 07/31/2004
RESPS:216 HOURS:108 COSTS(000):$0
Benefit Rights and Experience Report
FORMS: ETA-218
OMB NO: 1205-0178 EXPIRATION DATE: 08/31/2005
RESPS:212 HOURS:1,802 COSTS(000):$0
Contribution Operations
FORMS: ETA-581
OMB NO: 1205-0179 EXPIRATION DATE: 04/30/2003
RESPS:209,521 HOURS:216 COSTS(000):$0
Unemployment Compensation for Former Federal Employees Handbook
No. 391
FORMS: ES-931 ES-931A ES-933 ES-934 ES-935 ES-936 ES-939 ETA-8-32
OMB NO: 1205-0187 EXPIRATION DATE: 02/28/2005
RESPS:53 HOURS:159 COSTS(000):$0
Internal Fraud Activities
FORMS: ETA-9000
OMB NO: 1205-0190 EXPIRATION DATE: 06/30/2003
RESPS:8,780 HOURS:15,628 COSTS(000):$0
Customer Survey and TAA Customer Survey
FORMS: ETA-8562 ETA-8562A
OMB NO: 1205-0192 EXPIRATION DATE: 07/31/2003
RESPS:1,400 HOURS:350 COSTS(000):$0
Petition for Adjustment Assistance/Solicitud De Asistencia Para
Ajuste
FORMS: ETA-8560 ETA-8559
OMB NO: 1205-0197 EXPIRATION DATE: 10/31/2003
RESPS:1,500 HOURS:4,500 COSTS(000):$0
Business Confidential Data Request
FORMS: ETA-9014
OMB NO: 1205-0199 EXPIRATION DATE: 04/30/2003
RESPS:1 HOURS:1 COSTS(000):$0
Title XII Advances and Voluntary Repayment Process
FORMS: NONE
OMB NO: 1205-0207 EXPIRATION DATE: 09/30/2004
RESPS:1 HOURS:3 COSTS(000):$0
Procedures for Classifying Labor Surplus Areas
FORMS: NONE
OMB NO: 1205-0219 EXPIRATION DATE: 04/30/2003
RESPS:314,570 HOURS:84,741 COSTS(000):$0
Standard Job Corps Request for Proposal and Related Contractor
Information Gathering
FORMS: NONE
OMB NO: 1205-0222 EXPIRATION DATE: 04/30/2004
RESPS:3,180 HOURS:53 COSTS(000):$0
Administrative Procedures - 20 CFR 601 Including Form MA 8-7
FORMS: MA-8-7
OMB NO: 1205-0223 EXPIRATION DATE: 10/31/2003
RESPS:238,929 HOURS:47,520 COSTS(000):$0
Title 29 CFR Part 29 -- Labor Standards for the Registration of
Apprenticeship Programs
FORMS: ETA-671
OMB NO: 1205-0224 EXPIRATION DATE: 10/31/2003
RESPS:63,736 HOURS:6,264 COSTS(000):$0
Title 29 CFR Part 30 - Equal Employment Opportunity in
Apprenticeship and Training
FORMS: ETA-9039
OMB NO: 1205-0228 EXPIRATION DATE: 01/31/2004
RESPS:1 HOURS:14 COSTS(000):$0
Preliminary Estimates of Average Employer Contribution Rates
FORMS: ETA-205
OMB NO: 1205-0238 EXPIRATION DATE: 04/30/2004
RESPS:212 HOURS:39,388 COSTS(000):$985
Income and Eligibility Verification
FORMS: NONE
OMB NO: 1205-0240 EXPIRATION DATE: 04/30/2005
RESPS:28,824 HOURS:27,294 COSTS(000):$10,819
Labor Exchange Reporting System
FORMS: ETA-9002A 9002B 9002C 9002D 9002E VETS-200A-C
OMB NO: 1205-0245 EXPIRATION DATE: 03/31/2004
RESPS:47,160 HOURS:255,694 COSTS(000):$442
Benefit Accuracy Measurement
FORMS: ETAHANDBOOK395
OMB NO: 1205-0268 EXPIRATION DATE: 02/28/2005
RESPS:212 HOURS:212 COSTS(000):$0
Alien Claims Activity Report
FORMS: ETA-9016
OMB NO: 1205-0272 EXPIRATION DATE: 10/31/2003
RESPS:75 HOURS:225 COSTS(000):$0
Oil and Gas Drilling and Exploration Oilfield Services
FORMS: ETA-9018
OMB NO: 1205-0275 EXPIRATION DATE: 04/30/2003
RESPS:500 HOURS:1,000 COSTS(000):$26
Trade Adjustment Assistance/NAFTA (Financial Status/Requests for
funds Report)
FORMS: ETA-9023
OMB NO: 1205-0309 EXPIRATION DATE: 04/30/2004
RESPS:1 HOURS:4 COSTS(000):$0
Attestations by Employers Using Alien Crewmmembers for Longshore
Activities in U.S. Ports
FORMS: ETA-9033
OMB NO: 1205-0310 EXPIRATION DATE: 08/31/2003
RESPS:334,275 HOURS:310,421 COSTS(000):$0
Labor Condition Application and Requirements for Employers Using
Nonimmigrants on H-1B Visas
FORMS: ETA-9035 ETA-9035E WH4
OMB NO: 1205-0319 EXPIRATION DATE: 06/30/2005
RESPS:108 HOURS:216 COSTS(000):$0
State Alien Labor Certification Activity Report
FORMS: ETA-9037
OMB NO: 1205-0332 EXPIRATION DATE: 12/31/2005
RESPS:52 HOURS:91,000 COSTS(000):$0
Tax Performance System
FORMS: 407
OMB NO: 1205-0337 EXPIRATION DATE: 07/31/2004
RESPS:1,050 HOURS:2,100 COSTS(000):$0
NAFTA Customer Survey Data Request
FORMS: ETA-9044
OMB NO: 1205-0339 EXPIRATION DATE: 06/30/2003
RESPS:5,100 HOURS:21,850 COSTS(000):$0
Business Confidential Data Request and NAFTA Transitional
Adjustment Assistance Confidential Data Request
FORMS: ETA-9043 ETA-9043A
OMB NO: 1205-0342 EXPIRATION DATE: 06/30/2003
RESPS:4,100 HOURS:1,367 COSTS(000):$0
Petition for Trade Adjustment Assistance
FORMS: ETA-9042A ETA-9042A-1
OMB NO: 1205-0352 EXPIRATION DATE: 03/31/2005
RESPS:350 HOURS:1,050 COSTS(000):$0
Attestations by Employers Using Alien Crewmembers for Longshore
Activities at Locations in the State of Alaska
FORMS: ETA-9033A
OMB NO: 1205-0353 EXPIRATION DATE: 02/29/2004
RESPS:424 HOURS:106 COSTS(000):$0
Worker Profiling and Reemployment Services Activity and Worker
Profiling and Reemployment Services Outcomes
FORMS: ETA9048 ETA9049
OMB NO: 1205-0359 EXPIRATION DATE: 11/30/2004
RESPS:28,912 HOURS:38,168 COSTS(000):$0
Benefits, Timeliness and Quality (BTQ) Review System
FORMS: ETA-9050 ETA-9051 ETA-9052 ETA-9053 ETA-9054 ETA-9055 ETA-9056
ETA-9057
OMB NO: 1205-0371 EXPIRATION DATE: 12/31/2004
RESPS:1,101,028 HOURS:415,368 COSTS(000):$0
Work Opportunity Tax Credit (WOTC) and Welfare-to-work (WtW) Tax
Credit
FORMS: ETA-9057-59 ETA-9058 ETA-9061-63 ETA-9065
OMB NO: 1205-0373 EXPIRATION DATE: 04/30/2003
RESPS:1 HOURS:2,176 COSTS(000):$0
Baseline and Post-Program Employment Rate for the Youth
Opportunity Area Demonstration
FORMS: NONE
OMB NO: 1205-0385 EXPIRATION DATE: 03/31/2004
RESPS:1,204 HOURS:2,026 COSTS(000):$0
Welfare to Work (WtW) Formula/Competitive Cumulative Quarterly
Status Reports
FORMS: ETA-9068 ETA-9068-1
OMB NO: 1205-0391 EXPIRATION DATE: 08/31/2004
RESPS:2,302 HOURS:1,420 COSTS(000):$0
Center for Employment and Training (CET) Follow-up Survey
FORMS: NONE
OMB NO: 1205-0392 EXPIRATION DATE: 02/29/2004
RESPS:200 HOURS:9,500 COSTS(000):$325
Trade Act Participant Report (TAPR), a GPRA-compliant data
collection and reporting system
FORMS: NONE
OMB NO: 1205-0397 EXPIRATION DATE: 04/30/2005
RESPS:846 HOURS:282 COSTS(000):$0
Quantum Opportunity Program (QOP) Demonsration Net Impact
Evaluation
FORMS: NONE
OMB NO: 1205-0398 EXPIRATION DATE: 05/31/2004
RESPS:59 HOURS:1,475 COSTS(000):$0
Planning Guidance and Instructions for Submission of the
Strategic Five Year State Plan and Plan Modifications for Title
I of the Workforce Investment Act of 1988 (Workforce
Investment....
FORMS: NONE
OMB NO: 1205-0404 EXPIRATION DATE: 10/31/2005
RESPS:318 HOURS:80 COSTS(000):$0
Labor Certification for the Temporary Employment of Nonimmigrant
Aliens in Agriculture in the United States; Administrative
Measures to Improve Program Performance
FORMS: NONE
OMB NO: 1205-0407 EXPIRATION DATE: 04/30/2003
RESPS:57 HOURS:19,095 COSTS(000):$0
State Unified Plan Planning Guidance for State Unified Plans
Submitted Under Section 501 of the Workforce Invesment Act of
1998.
FORMS: NONE
OMB NO: 1205-0408 EXPIRATION DATE: 02/29/2004
RESPS:672 HOURS:672 COSTS(000):$0
Workforce Investment Act Cumulative Quarterly Financial
Reporting for Funds Allotted to States for: 1) Services to
Youth, 2) Services to Adults, 3) Services to Dislocated
Workers........
FORMS: 9076-A 9076-B 9076-C 9076-D 9076-E 9076-F
OMB NO: 1205-0410 EXPIRATION DATE: 06/30/2003
RESPS:16 HOURS:64 COSTS(000):$0
Employers' Use and Assessment of the WOTC and Welfare-to-Work
Tax Credit Programs
FORMS: NONE
OMB NO: 1205-0412 EXPIRATION DATE: 08/31/2003
RESPS:1,200 HOURS:300 COSTS(000):$0
Benefit-Cost Analysis of the Self-Employment Assistance Program
for the United States Unemployment Insurance Program
FORMS: NONE
OMB NO: 1205-0414 EXPIRATION DATE: 12/31/2005
RESPS:576 HOURS:51,840 COSTS(000):$0
MIS Requirements for Youth Opportunity Grants
FORMS: ETA-9086 ETA-9087
OMB NO: 1205-0415 EXPIRATION DATE: 05/31/2004
RESPS:172 HOURS:68 COSTS(000):$0
Attestations by Facilities Temporarily Employing H-1C
Nonimmigrant Aliens as Registered Nurses
FORMS: ETA-9081
OMB NO: 1205-0416 EXPIRATION DATE: 10/31/2003
RESPS:75 HOURS:1,500 COSTS(000):$0
Disability Employment and Initiatives Grant Program
FORMS: APR-ETA-9077 PCR-ETA-9078
OMB NO: 1205-0417 EXPIRATION DATE: 12/31/2003
RESPS:162 HOURS:46,656 COSTS(000):$0
PY 2002 Workforce Information Grant Plan and Annual Performance
Report
FORMS: NONE
OMB NO: 1205-0420 EXPIRATION DATE: 08/31/2005
RESPS:318 HOURS:758,236 COSTS(000):$19,905
WIA Management Information and Rreporting System
FORMS: ETA-9090 ETA-9091
OMB NO: 1205-0421 EXPIRATION DATE: 09/30/2005
RESPS:80,919 HOURS:33,373 COSTS(000):$0
O*NET Data Collection Program
FORMS: NONE
OMB NO: 1205-0423 EXPIRATION DATE: 03/31/2004
RESPS:1,800 HOURS:1,800 COSTS(000):$0
Workforce Investment Act (WIA) Employment and Training
Administration (ETA) Financial Reporting Requirements for Indian
and Native American (INA) Grantee Activities
FORMS: ETA-9080
OMB NO: 1205-0424 EXPIRATION DATE: 11/30/2004
RESPS:108 HOURS:3,024 COSTS(000):$0
Re-employment Services Plan Narrative and Progress Report
FORMS: ETA-9096
OMB NO: 1205-0425 EXPIRATION DATE: 12/31/2004
RESPS:42,833 HOURS:88,899 COSTS(000):$0
Reporting and Performance Standards System for Migrant and
Seasonal Farmworker Programs Under Title I, Section 167 of the
Workforce Investment Act (WIA)
FORMS: ETA-9093 ETA-9094 ETA-9095
OMB NO: 1205-0426 EXPIRATION DATE: 08/31/2004
RESPS:83,728 HOURS:17,485 COSTS(000):$0
Placement Verification and Follow-up of Job Corps Participants
FORMS: NONE
OMB NO: 1205-0428 EXPIRATION DATE: 10/31/2004
RESPS:636 HOURS:636 COSTS(000):$0
Workforce Investment Act (WIA) Employment and Training
Administration (ETA) Financial Reporting Requirements for
NATIONAL FARMWORKERS JOBS PROGRAM (NFJP) UNDER TITLE I of the Act
FORMS: ETA-9092
OMB NO: 1205-0429 EXPIRATION DATE: 07/31/2003
RESPS:5,080 HOURS:15,650 COSTS(000):$0
Reporting and Performance Standards System for Migrant and
Seasonal Farmworker :Youth Programs Under Title I-D, Section 167
of the Workforce Investment Act (WIA)
FORMS: ETA-9096 ETA-9097 ETA-9098
OMB NO: 1205-0430 EXPIRATION DATE: 11/30/2004
RESPS:636 HOURS:9,911 COSTS(000):$842
Resource Justification Model (RJM)
FORMS: NONE
OMB NO: 1205-0431 EXPIRATION DATE: 12/31/2004
RESPS:30 HOURS:30,187 COSTS(000):$4,399
Unemployment Insurance Data Validation Program
FORMS: HANDBOOK-361
OMB NO: 1205-0432 EXPIRATION DATE: 12/31/2004
RESPS:25 HOURS:960 COSTS(000):$0
Workforce Flexibility (Work-Flex) Program
FORMS: NONE
OMB NO: 1205-0433 EXPIRATION DATE: 12/31/2004
RESPS:5,300 HOURS:1,787 COSTS(000):$0
Reporting for Temporary Extended Unemployment Compensation
Program
FORMS: NONE
OMB NO: 1205-0434 EXPIRATION DATE: 07/31/2005
RESPS:320 HOURS:160 COSTS(000):$0
Workforce Investment Act (WIA) National Emergency Grant (NEG)
Financial Reporting
FORMS: ETA-9099
OMB NO: 1205-0435 EXPIRATION DATE: 12/31/2003
RESPS:52 HOURS:52 COSTS(000):$0
Study of the WIA Allocation Formula - Phase II
FORMS: NONE
OMB NO: 1205-0436 EXPIRATION DATE: 12/31/2003
RESPS:5,000 HOURS:7,500 COSTS(000):$0
Quick Turnaround Surveys on Workforce Investment Act
Implementation
FORMS: NONE
OMB NO: 1205-0438 EXPIRATION DATE: 01/31/2006
RESPS:605 HOURS:303 COSTS(000):$0
Local Area Survey of Self-Directed Labor Exchange Services
FORMS: NONE
OMB NO: 1205-0439 EXPIRATION DATE: 05/31/2003
RESPS:440 HOURS:333 COSTS(000):$0
Workfoce Investment Act: National Emergency Grants for Trade
Health Insurance Assistance-Application and Reporting Procedures
FORMS: ETA-9103 ETA-9104 ETA-9105 ETA-9106
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
88 3,260,444 2,804,813 $42,510
Employee Benefits Security Administration
OMB NO: 1210-0034 EXPIRATION DATE: 02/28/2005
RESPS:20,693 HOURS:1,954 COSTS(000):$8
Regulation--Alternative Method of Compliance for Certain
FORMS: NONE
OMB NO: 1210-0039 EXPIRATION DATE: 11/30/2003
RESPS:52,771,000 HOURS:710,134 COSTS(000):$243,226
Summar Plan Description Requirements under ERISA
FORMS: NONE
OMB NO: 1210-0040 EXPIRATION DATE: 04/30/2003
RESPS:235,000,000 HOURS:1,404,924 COSTS(000):$119,327
ERISA Summary Annual Report Requirement
FORMS: NONE
OMB NO: 1210-0048 EXPIRATION DATE: 02/28/2005
RESPS:74,872 HOURS:18,718 COSTS(000):$63
Suspension of Pension Benefits Regulation Pursuant to 29 CFR
FORMS: NONE
OMB NO: 1210-0049 EXPIRATION DATE: 02/28/2005
RESPS:82,240 HOURS:7,069 COSTS(000):$31
Prohibited Transaction Class Exemption 77-44 for Certain Benefit
Plans
FORMS: NONE
OMB NO: 1210-0053 EXPIRATION DATE: 11/30/2003
RESPS:118,000,000 HOURS:316,000 COSTS(000):$95,637
Employee Benefit Plan Claim Procedures under the Employee
Retirement Income Security Act of 1974 (ERISA)
FORMS: NONE
OMB NO: 1210-0058 EXPIRATION DATE: 06/30/2003
RESPS:3,187 HOURS:797 COSTS(000):$0
Prohibited Transaction Class Exemption 76-1 and Prohibited
Transaction Class Exemption 77-10
FORMS: NONE
OMB NO: 1210-0059 EXPIRATION DATE: 06/30/2005
RESPS:543,513 HOURS:99,033 COSTS(000):$188
Prohibited Transaction Exemption 86-128
FORMS: NONE
OMB NO: 1210-0060 EXPIRATION DATE: 02/28/2005
RESPS:116 HOURS:1 COSTS(000):$163
Procedure for Application for Exemption from the Prohibited
Transaction Provisions of Section 408(a) of the Employee
Retirement Income Security Act of 1974 (ERISA)
FORMS: NONE
OMB NO: 1210-0061 EXPIRATION DATE: 11/30/2004
RESPS:191,000 HOURS:31,900 COSTS(000):$71
Class Exemption 81-8 for Investment of Plan Assets in Certain
types of Short-Term Investments
FORMS: NONE
OMB NO: 1210-0062 EXPIRATION DATE: 06/30/2004
RESPS:126,000 HOURS:3,500 COSTS(000):$0
Prohibited Transaction Class Exemption 82-63
FORMS: NONE
OMB NO: 1210-0063 EXPIRATION DATE: 06/30/2004
RESPS:7,656 HOURS:1,531 COSTS(000):$3
Prohibited Transaction Class Exemption 92-6
FORMS: NONE
OMB NO: 1210-0064 EXPIRATION DATE: 01/31/2004
RESPS:25 HOURS:2 COSTS(000):$0
Prohibited Transaction Exemption 80-83--Involving Purchase of
Securities where issuer may use proceeds to Reduce indebtedness
to parties in interest
FORMS: NONE
OMB NO: 1210-0065 EXPIRATION DATE: 07/31/2004
RESPS:126,000 HOURS:10,500 COSTS(000):$48
Prohibited Transaction Class Exemption 81-6
FORMS: NONE
OMB NO: 1210-0066 EXPIRATION DATE: 04/30/2003
RESPS:83 HOURS:101 COSTS(000):$88
Advisory Opinion Procedure -- ERISA Procedure 76-1
FORMS: NONE
OMB NO: 1210-0074 EXPIRATION DATE: 11/30/2004
RESPS:1 HOURS:1 COSTS(000):$0
Prohibited Transaction Class Exemption T88-1
FORMS: NONE
OMB NO: 1210-0076 EXPIRATION DATE: 08/31/2004
RESPS:1,310 HOURS:1 COSTS(000):$283
Regulatoin Relating to Loans to Plan Participants and to the Plan
FORMS: NONE
OMB NO: 1210-0079 EXPIRATION DATE: 06/30/2004
RESPS:3 HOURS:2,384 COSTS(000):$0
Prohibited Transaction Class Exeption 91-55
FORMS: NONE
OMB NO: 1210-0080 EXPIRATION DATE: 06/30/2003
RESPS:1,275 HOURS:106 COSTS(000):$0
Prohibited Exemption 786-6
FORMS: NONE
OMB NO: 1210-0082 EXPIRATION DATE: 06/30/2003
RESPS:1,000 HOURS:83 COSTS(000):$0
Prohibition Transaction Exemption 91-38
FORMS: NONE
OMB NO: 1210-0083 EXPIRATION DATE: 06/30/2003
RESPS:128 HOURS:11 COSTS(000):$0
Prohibited Transaction Class Exemption 90-1 -- Pooled Separate
Accounts
FORMS: NONE
OMB NO: 1210-0084 EXPIRATION DATE: 02/28/2006
RESPS:66 HOURS:4,567 COSTS(000):$34
ERISA Technical Release 91-1
FORMS: NONE
OMB NO: 1210-0085 EXPIRATION DATE: 06/30/2003
RESPS:175 HOURS:15 COSTS(000):$0
Prohibited Transaction Class Exemption 94-20, Purchases and
Sales of Foreign Currencies
FORMS: NONE
OMB NO: 1210-0089 EXPIRATION DATE: 02/28/2005
RESPS:3,100 HOURS:109 COSTS(000):$74
Delinquesnt Filer Voluntary Compliance Program
FORMS: NONE
OMB NO: 1210-0090 EXPIRATION DATE: 02/28/2006
RESPS:39,100,000 HOURS:36,950 COSTS(000):$17,755
Disclosures for Participant Directed Individual Account Plans
Under ERISA Section 404(c)
FORMS: NONE
OMB NO: 1210-0091 EXPIRATION DATE: 11/30/2004
RESPS:1,080 HOURS:40 COSTS(000):$0
Prohibited Transaction Class Exemption 94-71
FORMS: NONE
OMB NO: 1210-0092 EXPIRATION DATE: 01/31/2004
RESPS:42,000 HOURS:3,500 COSTS(000):$0
Prohibited Transaction Exemption 75-1- Broker-Dealers, Reporting
Dealers, Banks Engaging in Securities Transactions
FORMS: NONE
OMB NO: 1210-0094 EXPIRATION DATE: 07/31/2004
RESPS:960 HOURS:960 COSTS(000):$0
Prohibited Transaction Class Exemption 85-68 to Permit Employee
Benefit Plans to Invest in Customer Notes of Employers
FORMS: NONE
OMB NO: 1210-0095 EXPIRATION DATE: 01/31/2004
RESPS:2,500 HOURS:208 COSTS(000):$0
Prohibited Transaction Exemption 88-59 Residential Mortgage
Financing Arrangements Involving Employee Benefit Plans
FORMS: NONE
OMB NO: 1210-0098 EXPIRATION DATE: 11/30/2004
RESPS:42 HOURS:53 COSTS(000):$38
Prohibited Transaction Class Exemption 96-62; Process for
Expedited Approval of an Exemption for Prohibited Transaction
FORMS: NONE
OMB NO: 1210-0100 EXPIRATION DATE: 05/31/2003
RESPS:1 HOURS:3 COSTS(000):$0
Definition of Plan Assets - Participant Contributions
FORMS: NONE
OMB NO: 1210-0101 EXPIRATION DATE: 06/30/2003
RESPS:9,602,000 HOURS:7,200 COSTS(000):$841
Notice of Enrollment Rights
FORMS: NONE
OMB NO: 1210-0102 EXPIRATION DATE: 06/30/2003
RESPS:8,570,000 HOURS:9,004 COSTS(000):$1,088
Notice of Pre-Existing Condition Exclusion
FORMS: NONE
OMB NO: 1210-0103 EXPIRATION DATE: 06/30/2003
RESPS:44,396,000 HOURS:351,150 COSTS(000):$34,689
Establishing Creditable Coverage
FORMS: NONE
OMB NO: 1210-0104 EXPIRATION DATE: 08/31/2003
RESPS:75 HOURS:2,625 COSTS(000):$162
Prohibition Transaction Exemption 97-41
FORMS: NONE
OMB NO: 1210-0105 EXPIRATION DATE: 11/30/2004
RESPS:10,000 HOURS:333 COSTS(000):$5
Notice to Participants and Beneficiaries and the Federal
Government to Electing one Percent Increased Cost Exemption
FORMS: NONE
OMB NO: 1210-0106 EXPIRATION DATE: 10/31/2004
RESPS:200 HOURS:10 COSTS(000):$0
Calculation and Disclosure of Documentation of Eligibility for
Exemption
FORMS: NONE
OMB NO: 1210-0110 EXPIRATION DATE: 10/31/2004
RESPS:863,682 HOURS:1,847,163 COSTS(000):$546,789
Form 5500 Annual Return/Report of Employee Benefit Plan
FORMS: FORM-5500
OMB NO: 1210-0111 EXPIRATION DATE: 02/28/2005
RESPS:8,400 HOURS:4,200 COSTS(000):$0
Prohibited Transactions Exemption 98-54 Relating to Certain
Employee Benefit Plan Foreign Exchange Transactions Executed
Pursuant to Standing Instructions
FORMS: NONE
OMB NO: 1210-0112 EXPIRATION DATE: 12/31/2005
RESPS:1,000 HOURS:95 COSTS(000):$4
Furnishing Documents to the Secretary of Labor on Request under
ERISA section 104(a)(6)
FORMS: NONE
OMB NO: 1210-0113 EXPIRATION DATE: 04/30/2003
RESPS:770,000 HOURS:785,000 COSTS(000):$1,100
National Medical Support Notice -- Part B
FORMS: NONE
OMB NO: 1210-0114 EXPIRATION DATE: 01/31/2006
RESPS:123,500 HOURS:466,667 COSTS(000):$46
Disclosures by Insurers to General Account Policyholders
FORMS: NONE
OMB NO: 1210-0115 EXPIRATION DATE: 04/30/2003
RESPS:840 HOURS:9,100 COSTS(000):$421
Proposed Class Exemption for Cross-Trades of Securities by Index
and Model-Driven Funds
FORMS: NONE
OMB NO: 1210-0116 EXPIRATION DATE: 11/30/2003
RESPS:2,678 HOURS:874 COSTS(000):$394
Annual Report for Multiple Employer Welfare Arrangements and
Certain Entities Claiming Exception (Form M-1)
FORMS: M-1
OMB NO: 1210-0117 EXPIRATION DATE: 05/31/2005
RESPS:7,200 HOURS:2,400 COSTS(000):$3
Application for EFAST-1 Electronic Signature and Codes for EFAST
Transmitters and Software Developers
FORMS: EFAST-1
OMB NO: 1210-0118 EXPIRATION DATE: 11/30/2003
RESPS:1,050 HOURS:5,710 COSTS(000):$272
The Voluntary Fiduciary Correction Program and Prohibited
Transaction Class Exemption
FORMS: NONE
OMB NO: 1210-0119 EXPIRATION DATE: 01/31/2004
RESPS:45 HOURS:1 COSTS(000):$104
Petition for Finding under Section 3(40) of ERISA
FORMS: NONE
OMB NO: 1210-0121 EXPIRATION DATE: 05/31/2005
RESPS:50,000 HOURS:5,042 COSTS(000):$2,447
Consent to Receive Employee Benefit Plan Disclosure
Electronically
FORMS: NONE
OMB NO: 1210-0122 EXPIRATION DATE: 04/30/2003
RESPS:11,956,600 HOURS:166,129 COSTS(000):$9,351
Notice of Blackout Period Under ERISA
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
49 522,463,296 6,317,858 $1,074,753
Employment Standards Administration
OMB NO: 1215-0001 EXPIRATION DATE: 06/30/2004
RESPS:39,000 HOURS:13,000 COSTS(000):$0
Employment Information Forms
FORMS: WH-3 WH-3SP.
OMB NO: 1215-0005 EXPIRATION DATE: 11/30/2004
RESPS:16,550 HOURS:12,400 COSTS(000):$2
Applications to Employ Special Industrial Homeworkers and
FORMS: WH-2 WH-226 WH-226A
OMB NO: 1215-0013 EXPIRATION DATE: 09/30/2003
RESPS:18,985 HOURS:9,757 COSTS(000):$0
Applications to Employ Homeworkers Piece Rate Measurements,
Homeworker Handbooks
FORMS: WH-46 WH-75
OMB NO: 1215-0017 EXPIRATION DATE: 05/31/2004
RESPS:5,800,000 HOURS:926,156 COSTS(000):$0
Records To Be Kept By Employers - FLSA
FORMS: NONE
OMB NO: 1215-0022 EXPIRATION DATE: 03/31/2006
RESPS:26,100 HOURS:6,525 COSTS(000):$10
Payment of Compensation Without Award
FORMS: LS-206
OMB NO: 1215-0023 EXPIRATION DATE: 03/31/2006
RESPS:18,900 HOURS:4,725 COSTS(000):$8
Notice of Controversion of Right to Compensation
FORMS: LS-207
OMB NO: 1215-0024 EXPIRATION DATE: 03/31/2006
RESPS:18,950 HOURS:4,738 COSTS(000):$11
Notice of Final Payment or Suspension of Compensation Benefits
FORMS: LS-208
OMB NO: 1215-0027 EXPIRATION DATE: 04/30/2005
RESPS:195 HOURS:49 COSTS(000):$0
Certification of Funeral Expenses
FORMS: LS-265
OMB NO: 1215-0028 EXPIRATION DATE: 08/31/2003
RESPS:50 HOURS:38 COSTS(000):$0
Economic Survey Schedule
FORMS: WH-1
OMB NO: 1215-0031 EXPIRATION DATE: 10/31/2004
RESPS:26,660 HOURS:6,705 COSTS(000):$11
Employer's First Report of Injury or Occupational Disease
LS-202; Physician's Report on Impairment of Vision LS-205;
Employer's Supplementary Report of Accident or Occupational
Illness LS-210
FORMS: LS-202 LS-205 LS-210
OMB NO: 1215-0032 EXPIRATION DATE: 10/31/2005
RESPS:350 HOURS:69 COSTS(000):$0
Applications for Authority to Employ Full-Time Students at
Subminimum Wages in Retail or Service Establishments or
Agriculture
FORMS: WH-200 WH-202
OMB NO: 1215-0034 EXPIRATION DATE: 12/31/2005
RESPS:300 HOURS:75 COSTS(000):$0
Agreement and Undertaking
FORMS: OWCP-1
OMB NO: 1215-0036 EXPIRATION DATE: 07/31/2004
RESPS:3,600 HOURS:300 COSTS(000):$166
Vehicle Mechanical Inspection Report for Transportation Subject
to DOT Requirements; Subject to DOL Safety Standards
FORMS: WH-514 WH-514A
OMB NO: 1215-0037 EXPIRATION DATE: 08/31/2003
RESPS:9,000 HOURS:4,600 COSTS(000):$2
Application for Farm Labor Contractor and Farm Labor Contractor
Employee Certificate of Registration
FORMS: WH-530
OMB NO: 1215-0046 EXPIRATION DATE: 02/28/2005
RESPS:75,000 HOURS:25,000 COSTS(000):$0
Report of Construction Contractor's Wage Rates
FORMS: WD-10
OMB NO: 1215-0052 EXPIRATION DATE: 08/31/2005
RESPS:20,200 HOURS:9,116 COSTS(000):$4
1) Miner's Claim for Benefits Under the Black Lung Benefits Act;
2) Employment History; 3) Miner Reimbursement Form
FORMS: CM-911 CM-911A CM-915
OMB NO: 1215-0054 EXPIRATION DATE: 06/30/2004
RESPS:8,700 HOURS:1,450 COSTS(000):$2
Medical Travel Refund Requst
FORMS: OWCP-957
OMB NO: 1215-0055 EXPIRATION DATE: 11/30/2003
RESPS:1,610,030 HOURS:187,663 COSTS(000):$0
Health Insurance Claim Form
FORMS: OWCP-1500
OMB NO: 1215-0056 EXPIRATION DATE: 04/30/2005
RESPS:1,700 HOURS:800 COSTS(000):$1
(1) Comparability of Current Work to Coal Mine Employment; (2)
Coal Mine Employment Afidavit; (3) Afidavit of Deceased Miner's
Condition
FORMS: CM-913 CM-918 CM-1093
OMB NO: 1215-0057 EXPIRATION DATE: 11/30/2003
RESPS:2,700 HOURS:225 COSTS(000):$0
Authorization for Release of Medical Information
FORMS: CM-936
OMB NO: 1215-0058 EXPIRATION DATE: 10/31/2004
RESPS:10,800 HOURS:2,283 COSTS(000):$4
Operator Controversion, Operator Response, Operator Response to
Response to Notice of Claim
FORMS: CM-970 CM-970A CM-2970 CM-2970A
OMB NO: 1215-0059 EXPIRATION DATE: 03/31/2004
RESPS:4,000 HOURS:667 COSTS(000):$2
Notice of Issuance of Insurance Policy
FORMS: CM-921
OMB NO: 1215-0060 EXPIRATION DATE: 10/31/2004
RESPS:3,522 HOURS:881 COSTS(000):$12
Request for State or Federal Workers' Compensation Information
FORMS: CM-905
OMB NO: 1215-0061 EXPIRATION DATE: 04/30/2004
RESPS:1,000 HOURS:167 COSTS(000):$0
Certification by School Official
FORMS: CM-981
OMB NO: 1215-0064 EXPIRATION DATE: 08/31/2003
RESPS:9,000 HOURS:1,800 COSTS(000):$3
Notice of Termination, Suspension, Reduction or Increase in
Benefit Payments
FORMS: CM-908
OMB NO: 1215-0066 EXPIRATION DATE: 11/30/2005
RESPS:109,725 HOURS:118,503 COSTS(000):$44
Request for Examination and/or Treatment
FORMS: LS-1
OMB NO: 1215-0067 EXPIRATION DATE: 06/30/2005
RESPS:7,000 HOURS:3,500 COSTS(000):$0
Rehabilitation Plan and Award
FORMS: OWCP-16
OMB NO: 1215-0069 EXPIRATION DATE: 08/31/2004
RESPS:2,500 HOURS:333 COSTS(000):$1
Survivor's Form for Benefits
FORMS: CM-912
OMB NO: 1215-0072 EXPIRATION DATE: 07/31/2003
RESPS:95,311 HOURS:9,967,675 COSTS(000):$23
OFCCP Recordkeeping and Reporting Requirements--Supply and
Service
FORMS: NONE
OMB NO: 1215-0073 EXPIRATION DATE: 12/31/2004
RESPS:43 HOURS:22 COSTS(000):$0
Application for Continuation of Death Benefit for Student
FORMS: LS-266
OMB NO: 1215-0078 EXPIRATION DATE: 03/31/2004
RESPS:12,700 HOURS:7,850 COSTS(000):$17
Representative Fee Request
FORMS: NONE
OMB NO: 1215-0080 EXPIRATION DATE: 11/30/2005
RESPS:15 HOURS:5 COSTS(000):$0
Application for Authority for an Institution on Higher Education
to Employ its Full-time Students at Subminimum Wages Under
Regulations Part 519
FORMS: WH-201
OMB NO: 1215-0083 EXPIRATION DATE: 01/31/2006
RESPS:10 HOURS:2 COSTS(000):$0
Application for Federal Certificate of Age
FORMS: WH-14
OMB NO: 1215-0084 EXPIRATION DATE: 06/30/2005
RESPS:1 HOURS:2,208 COSTS(000):$0
Report of Changes That May Afect Your Black Lung Benefits
FORMS: CM-929
OMB NO: 1215-0085 EXPIRATION DATE: 05/31/2005
RESPS:6,800 HOURS:1,088 COSTS(000):$3
Pre-Hearing Statement
FORMS: LS-18
OMB NO: 1215-0090 EXPIRATION DATE: 04/30/2005
RESPS:26,000 HOURS:6,334 COSTS(000):$0
Report of Ventilator Study (CM-907), Roentgenograhic
Interpretation (CM-933) Roentgenographic Quality Rereading
(CM-933b), Medical History and Examination for Coal Mine.......
FORMS: CM-907 CM-933 CM-933B CM-988 CM-1159 CM-2907
OMB NO: 1215-0103 EXPIRATION DATE: 08/31/2005
RESPS:287,660 HOURS:29,403 COSTS(000):$106
FECA Medical Report Forms, Claim for Compensation
FORMS: CA-7 CA-16 CA-17 CA-20 CA-1090 CA-1303 CA-1305 CA-1331 CA-1087
CA-1332
OMB NO: 1215-0105 EXPIRATION DATE: 03/31/2004
RESPS:500 HOURS:125 COSTS(000):$0
Request for Employment Information
FORMS: CA-1027
OMB NO: 1215-0112 EXPIRATION DATE: 06/30/2003
RESPS:1,700 HOURS:425 COSTS(000):$0
Request for Earnings Information
FORMS: LS-426
OMB NO: 1215-0113 EXPIRATION DATE: 11/30/2005
RESPS:12,000 HOURS:4,800 COSTS(000):$0
Certificate of Medical Necessity
FORMS: CM-893
OMB NO: 1215-0116 EXPIRATION DATE: 08/31/2004
RESPS:23 HOURS:31 COSTS(000):$0
Notice of Law Enforcement Officer's Injury or Occupational
Disease (CA-721); Notice of Law Enforcement Officer's Death
(CA-722)
FORMS: CA-721 CA-722
OMB NO: 1215-0119 EXPIRATION DATE: 03/31/2006
RESPS:462,000 HOURS:2 COSTS(000):$0
Requirements of a Bona Fide Thrift or Savings Plan (29 CFR Part
547) and Requirements of a Bona Fide Profit-Sharing Plan or
Trust (29 CFR Part 549)
FORMS: NONE
OMB NO: 1215-0120 EXPIRATION DATE: 08/31/2004
RESPS:1 HOURS:4 COSTS(000):$0
29 CFR Part 575 - Waiver of Child Labor Provisions for
Agricultural Employment of 10 and 11 Year Old Minors in Hand
Harvesting of Short Season Crops
FORMS: NONE
OMB NO: 1215-0121 EXPIRATION DATE: 03/31/2006
RESPS:14,014 HOURS:7,145 COSTS(000):$0
Work Experience and Career Exploration Programs (20 CFR 570.35A)
FORMS: NONE
OMB NO: 1215-0124 EXPIRATION DATE: 06/30/2004
RESPS:150 HOURS:1 COSTS(000):$0
Maintenance of Receipt for Benefits Paid by a Coal Mine Operator
FORMS: CM-200
OMB NO: 1215-0131 EXPIRATION DATE: 11/30/2004
RESPS:1,046 HOURS:1,339 COSTS(000):$0
OFCCP Complaint Form
FORMS: CC-4
OMB NO: 1215-0137 EXPIRATION DATE: 03/31/2004
RESPS:20,100 HOURS:2,497 COSTS(000):$8
Provider Enrollment Form
FORMS: OWCP01168
OMB NO: 1215-0140 EXPIRATION DATE: 04/30/2004
RESPS:3,506 HOURS:881 COSTS(000):$1
Davis-Bacon and Related Acts/Contract Work Hours and Safety
Standards Act Reporting Requirements - Regulations, 29 CFR Part 5
FORMS: NONE
OMB NO: 1215-0144 EXPIRATION DATE: 10/31/2003
RESPS:4,500 HOURS:4,500 COSTS(000):$2
Overpayment Recovery Questionnaire
FORMS: OWCP-20
OMB NO: 1215-0146 EXPIRATION DATE: 09/30/2005
RESPS:1,300 HOURS:650 COSTS(000):$0
Housing Terms and Conditions
FORMS: WH-521
OMB NO: 1215-0148 EXPIRATION DATE: 08/31/2003
RESPS:34,000,000 HOURS:566,667 COSTS(000):$0
Wage Statement
FORMS: WH-501 WH-501S
OMB NO: 1215-0149 EXPIRATION DATE: 03/31/2006
RESPS:9,280,960 HOURS:8,700,000 COSTS(000):$371
Optional Use Payroll Form Under the Davis-Bacon Act
FORMS: WH-347
OMB NO: 1215-0150 EXPIRATION DATE: 09/30/2004
RESPS:64,026 HOURS:62,554 COSTS(000):$0
Labor Standards for Federal Service Contracts - 29 CFR, Part 4
FORMS: NONE
OMB NO: 1215-0151 EXPIRATION DATE: 02/28/2005
RESPS:50,000 HOURS:16,667 COSTS(000):$18
Request for Information on Earnings, Dual Benefits, Dependents
and Third Party Settlements
FORMS: CA-1032
OMB NO: 1215-0154 EXPIRATION DATE: 05/31/2005
RESPS:5,900 HOURS:492 COSTS(000):$2
Claim for Continuance of Compensation
FORMS: CA-12
OMB NO: 1215-0155 EXPIRATION DATE: 04/30/2004
RESPS:1,895 HOURS:1,210 COSTS(000):$0
Claim for Compensation by Dependents Information Reports
FORMS: CA-5 CA-5B CA-1031 CA-1074 CA-1085 CA-1093 CA-1615 CA-1617
CA-1618
OMB NO: 1215-0158 EXPIRATION DATE: 06/30/2005
RESPS:60 HOURS:4 COSTS(000):$0
Occupancy Certificate - Migrant and Seasonal Agricultural Worker
Protection Act
FORMS: WH-520
OMB NO: 1215-0160 EXPIRATION DATE: 11/30/2003
RESPS:189,144 HOURS:76,326 COSTS(000):$59
Regulations Governing the Administration of the Longshore and
Harbor Workers' Compensation Act
FORMS: LS-200 LS-271 LS-201 LS-513 LS-267 LS-203 LS-204 LS-262
OMB NO: 1215-0161 EXPIRATION DATE: 09/30/2003
RESPS:15,600 HOURS:2,605 COSTS(000):$0
Rehabilitation Maintenance Certificate
FORMS: OWCP-17
OMB NO: 1215-0163 EXPIRATION DATE: 12/31/2003
RESPS:103,711 HOURS:4,841,475 COSTS(000):$0
Recordkeeping and Reporting Requirements, Construction
FORMS: CC-41
OMB NO: 1215-0166 EXPIRATION DATE: 03/31/2006
RESPS:2,000 HOURS:667 COSTS(000):$1
Request to be Selected as Payee
FORMS: CM910
OMB NO: 1215-0167 EXPIRATION DATE: 07/31/2005
RESPS:550 HOURS:275 COSTS(000):$0
Notice of Recurrence
FORMS: CA-2A
OMB NO: 1215-0170 EXPIRATION DATE: 10/31/2005
RESPS:328,000 HOURS:82,406 COSTS(000):$0
Application of the Employee Polygraph Protection Act
FORMS: NONE
OMB NO: 1215-0171 EXPIRATION DATE: 11/30/2004
RESPS:500 HOURS:350 COSTS(000):$0
Application for Approval of a Representative's Fee in Black Laor
FORMS: CM-972
OMB NO: 1215-0173 EXPIRATION DATE: 10/31/2005
RESPS:3,098 HOURS:3,569 COSTS(000):$0
Representative Payee Report, Representative Payee Report (Short
Form), Physician's/Medical Officer's Report
FORMS: CM-623 CM-623S CM-787
OMB NO: 1215-0175 EXPIRATION DATE: 06/30/2003
RESPS:15,000 HOURS:5,000 COSTS(000):$0
The Remedial Education Provisions of the Fair Labor Standards Act
FORMS: NONE
OMB NO: 1215-0176 EXPIRATION DATE: 12/31/2003
RESPS:170,755 HOURS:29,261 COSTS(000):$0
Uniform Health Insurance Claim Form
FORMS: OWCP-92(UB-92)
OMB NO: 1215-0178 EXPIRATION DATE: 06/30/2004
RESPS:80 HOURS:40 COSTS(000):$0
Claim for Reimbursement-Assisted Reemployment
FORMS: CA-2231
OMB NO: 1215-0181 EXPIRATION DATE: 07/31/2003
RESPS:10,107,000 HOURS:718,529 COSTS(000):$0
29 CFR Part 825, The Family and Medical Leave Act of 1993
FORMS: WH-380 WH-381
OMB NO: 1215-0182 EXPIRATION DATE: 08/31/2005
RESPS:7,000 HOURS:1,750 COSTS(000):$0
Rehabilitation Action Report
FORMS: OWCP-44
OMB NO: 1215-0187 EXPIRATION DATE: 02/28/2005
RESPS:3.24000000 HOURS:73,067 COSTS(000):$29
Worker Information - Terms and Conditions of Employment
FORMS: WH-516-ENGLISH WH-516-ESPANOL
OMB NO: 1215-0188 EXPIRATION DATE: 07/31/2004
RESPS:30,369 HOURS:185,152 COSTS(000):$0
Labor Organization and Auxilliary Reports
FORMS: LM-1/LM-2/LM-3 LM-4/LM-10 LM-15/LM-15A LM-16/LM-20 LM-21 LM-30
S-1
OMB NO: 1215-0192 EXPIRATION DATE: 07/31/2003
RESPS:651 HOURS:325 COSTS(000):$0
Employment Under Special Certificate of Apprentices, Messengers
and Learners (including Student Learners)
FORMS: WH-205 WH-209
OMB NO: 1215-0193 EXPIRATION DATE: 01/31/2004
RESPS:41,907 HOURS:6,957 COSTS(000):$15
Claimant Medical Reimbursement Form
FORMS: CA-915
OMB NO: 1215-0194 EXPIRATION DATE: 01/31/2004
RESPS:607,762 HOURS:50,443 COSTS(000):$0
The NCPDP Universal Pharmacy Billing Form
FORMS: 79-1A
OMB NO: 1215-0196 EXPIRATION DATE: 06/30/2003
RESPS:50,000 HOURS:1,050,000 COSTS(000):$150
Equal Opportunity Survey
FORMS: NONE
OMB NO: 1215-0197 EXPIRATION DATE: 07/31/2004
RESPS:93,116 HOURS:40,396 COSTS(000):$24
Energy Employee Occupational Illness Compensation Program Act
Forms (various)
FORMS: EE-1 EE-2 EE-3 EE-4 EE-7 EE-8 EE-9 EE-20 EE-915
OMB NO: 1215-0199 EXPIRATION DATE: 01/31/2006
RESPS:2,000 HOURS:1,000 COSTS(000):$0
Alternate Employment Information Request
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
78 63,964,984 27,895,699 $1,112
Occupational Safety and Health Administration
OMB NO: 1218-0003 EXPIRATION DATE: 10/31/2004
RESPS:340 HOURS:81 COSTS(000):$1,433
GEAR Certification (29 CFR Part 1919)
FORMS: OSHA-70 OSHA-71 OSHA-72
OMB NO: 1218-0010 EXPIRATION DATE: 09/30/2005
RESPS:1,743 HOURS:1,040 COSTS(000):$114
Vinyl Chloride
FORMS: NONE
OMB NO: 1218-0011 EXPIRATION DATE: 03/31/2005
RESPS:885,304 HOURS:134,819 COSTS(000):$0
Subpart A (General Provisions) and Subpart B (Confined and
Enclosed Spaces and Other Dangerous Atmpospheres) of 29 CFR part
1915
FORMS: NONE
OMB NO: 1218-0020 EXPIRATION DATE: 06/30/2004
RESPS:200 HOURS:11,050 COSTS(000):$0
Application for Training Grant
FORMS: NONE
OMB NO: 1218-0048 EXPIRATION DATE: 02/29/2004
RESPS:17,982,447 HOURS:5,175,645 COSTS(000):$98,815
Noise (29 CFR 1910.95)
FORMS: NONE
OMB NO: 1218-0054 EXPIRATION DATE: 11/30/2004
RESPS:2,900 HOURS:97 COSTS(000):$9
Cranes and Derricks Standards for Construction: Recording Tests
for toxic Gases and Oxygen-Deficient Atmospheres in Enclosed
Speces
FORMS: NONE
OMB NO: 1218-0061 EXPIRATION DATE: 09/30/2005
RESPS:185,384 HOURS:70,340 COSTS(000):$6,526
Cotton Dust 29CFR 1910.1043
FORMS: NONE
OMB NO: 1218-0064 EXPIRATION DATE: 12/31/2004
RESPS:55,132 HOURS:14,767 COSTS(000):$1
Notice of Alleged Safety and Health Hazards, OSHA-7 Form
FORMS: OSHA-7
OMB NO: 1218-0065 EXPIRATION DATE: 02/29/2004
RESPS:5,030,002 HOURS:613,127 COSTS(000):$0
Access to Employee Exposure and Medical Records (29 CFR
1910.1020)
FORMS: NONE
OMB NO: 1218-0067 EXPIRATION DATE: 02/28/2005
RESPS:88,578 HOURS:57,464 COSTS(000):$117
Underground Construction Standard
FORMS: NONE
OMB NO: 1218-0069 EXPIRATION DATE: 01/31/2005
RESPS:4,005,966 HOURS:205,397 COSTS(000):$0
Commercial Diving Operations (29 CFR Part 1910, Subpart T)
FORMS: NONE
OMB NO: 1218-0070 EXPIRATION DATE: 05/31/2003
RESPS:123 HOURS:41 COSTS(000):$0
Reports of Injuries to Employees Operating Mechanical Power
Presses (29 CFR 1910.217(g))
FORMS: NONE
OMB NO: 1218-0072 EXPIRATION DATE: 09/30/2005
RESPS:460,242,484 HOURS:7,553,465 COSTS(000):$494
Hazard Communication 29 CFR 1910.1200; Parts 1915, 1917, 1918,
1926, 1928
FORMS: NONE
OMB NO: 1218-0075 EXPIRATION DATE: 01/31/2005
RESPS:8,391 HOURS:6,042 COSTS(000):$0
Fire Brigades (29 CFR 1910.156)
FORMS: NONE
OMB NO: 1218-0085 EXPIRATION DATE: 11/30/2005
RESPS:2,187 HOURS:1,634 COSTS(000):$86
The 13 Carcinogens Standard (29 CFR 1910, 1003, 1915.1003, and
1926.1103)
FORMS: NONE
OMB NO: 1218-0092 EXPIRATION DATE: 12/31/2005
RESPS:4,020,412 HOURS:1,229,515 COSTS(000):$138,134
Lead in General Industry
FORMS: NONE
OMB NO: 1218-0093 EXPIRATION DATE: 11/30/2004
RESPS:140,325 HOURS:5,726 COSTS(000):$0
Construction Standards on Posting Emergency Telephone Numbers
and Floor Load Limits
FORMS: NONE
OMB NO: 1218-0095 EXPIRATION DATE: 10/31/2004
RESPS:280,000 HOURS:22,400 COSTS(000):$0
Concrete and Masonry Construction
FORMS: NONE
OMB NO: 1218-0096 EXPIRATION DATE: 03/31/2006
RESPS:863 HOURS:69 COSTS(000):$0
Temporary Labor Camps (29 CFR 1910.142)
FORMS: NONE
OMB NO: 1218-0099 EXPIRATION DATE: 09/30/2004
RESPS:18,112,941 HOURS:6,685,348 COSTS(000):$72,901
Respiratory Protection
FORMS: NONE
OMB NO: 1218-0100 EXPIRATION DATE: 06/30/2004
RESPS:244 HOURS:2,928 COSTS(000):$0
Grantee Quarterly Progress Report
FORMS: OSHA-171
OMB NO: 1218-0101 EXPIRATION DATE: 11/30/2005
RESPS:1 HOURS:1 COSTS(000):$0
1,2-Dibromo-3-Chloropropane (DBCP) 29 CFR 1910.1044
FORMS: NONE
OMB NO: 1218-0103 EXPIRATION DATE: 09/30/2004
RESPS:159,043 HOURS:29,661 COSTS(000):$1,720
Ionizing Radiation 29 CFR 1910.1096
FORMS: NONE
OMB NO: 1218-0104 EXPIRATION DATE: 09/30/2005
RESPS:15,929 HOURS:4,860 COSTS(000):$396
Inorganic Arsenic (29 CFR 1910.1018)
FORMS: NONE
OMB NO: 1218-0108 EXPIRATION DATE: 09/30/2003
RESPS:232,564 HOURS:49,200 COSTS(000):$7,056
Ethylene Oxide (29 CFR 1910.1047)
FORMS: NONE
OMB NO: 1218-0110 EXPIRATION DATE: 08/31/2005
RESPS:84,688 HOURS:17,530 COSTS(000):$0
Consultant Agreements
FORMS: FORM-33
OMB NO: 1218-0113 EXPIRATION DATE: 09/30/2004
RESPS:132,737 HOURS:218,090 COSTS(000):$0
Construction Crane or Derrick Annual Inspection Record
FORMS: NONE
OMB NO: 1218-0115 EXPIRATION DATE: 11/30/2004
RESPS:67,773 HOURS:5,416 COSTS(000):$431
Cranes and Derricks Standards for Construction: Notification of
Operational Specification and Hand Signals
FORMS: NONE
OMB NO: 1218-0121 EXPIRATION DATE: 09/30/2004
RESPS:167,569 HOURS:124,357 COSTS(000):$0
Powered Platforms for Building Maintenace (29 CFR 1910.66)
FORMS: NONE
OMB NO: 1218-0126 EXPIRATION DATE: 09/30/2005
RESPS:13,492 HOURS:2,922 COSTS(000):$223
Acrylonitrile (29 CFR 1910.1045)
FORMS: NONE
OMB NO: 1218-0128 EXPIRATION DATE: 09/30/2005
RESPS:67,345 HOURS:56,238 COSTS(000):$1,126
Coke Oven Emissions (29 CFR 1910.1028)
FORMS: NONE
OMB NO: 1218-0129 EXPIRATION DATE: 05/31/2003
RESPS:185,719 HOURS:125,195 COSTS(000):$8,180
Benzene 29 CFR 1910.1028
FORMS: NONE
OMB NO: 1218-0130 EXPIRATION DATE: 03/31/2005
RESPS:2,829,582 HOURS:84,803 COSTS(000):$933
Electrical Standards for Construction (29 CFR Part 1926, Subpart
K)
FORMS: NONE
OMB NO: 1218-0131 EXPIRATION DATE: 02/28/2005
RESPS:866,756 HOURS:269,273 COSTS(000):$18,235
Occupational Exposure to Hazardous Chemicals in Laboratories
FORMS: NONE
OMB NO: 1218-0132 EXPIRATION DATE: 09/30/2004
RESPS:112,000 HOURS:30,225 COSTS(000):$0
Specifications for Accident Prevention Signs and Tags (29 CFR
1910.145)
FORMS: NONE
OMB NO: 1218-0133 EXPIRATION DATE: 03/31/2004
RESPS:65,893 HOURS:23,849 COSTS(000):$1,625
Asbestos in General Industry 1910.1001
FORMS: NONE
OMB NO: 1218-0134 EXPIRATION DATE: 12/31/2005
RESPS:53,145,470 HOURS:5,569,963 COSTS(000):$30,730
Asbestos in Construction 1926.1101
FORMS: NONE
OMB NO: 1218-0137 EXPIRATION DATE: 10/31/2004
RESPS:10,000 HOURS:120,011 COSTS(000):$307
Design of Cave-in Protection Systems
FORMS: NONE
OMB NO: 1218-0143 EXPIRATION DATE: 04/30/2003
RESPS:1 HOURS:1 COSTS(000):$0
Presence Sensing Device Initiation (PSDI) (29 CFR 1910.217(h))
FORMS: NONE
OMB NO: 1218-0145 EXPIRATION DATE: 02/29/2004
RESPS:1,569,329 HOURS:591,079 COSTS(000):$56,531
Formaldehyde (29 CFR 1910.1048)
FORMS: NONE
OMB NO: 1218-0147 EXPIRATION DATE: 02/29/2004
RESPS:58 HOURS:1,345 COSTS(000):$0
Definition and Requirements for a Nationally Recognized Testing
Laboratory (29 CFR 1910.7)
FORMS: NONE
OMB NO: 1218-0150 EXPIRATION DATE: 05/31/2004
RESPS:94,561,759 HOURS:2,462,279 COSTS(000):$0
Standard on the Control of Hazardous Energy Sources
(Lockout/Tagout) (29 CFR 1910.147)
FORMS: NONE
OMB NO: 1218-0151 EXPIRATION DATE: 11/30/2004
RESPS:2,750 HOURS:229 COSTS(000):$0
Cranes and Derricks Standards for Construction: Posting Weight
and Load Capacity of Personnel Platforms
FORMS: NONE
OMB NO: 1218-0170 EXPIRATION DATE: 05/31/2003
RESPS:335,944 HOURS:2,909 COSTS(000):$82
1,3-Butadiene (29 CFR 1910.1051)
FORMS: NONE
OMB NO: 1218-0172 EXPIRATION DATE: 07/31/2004
RESPS:5,000 HOURS:417 COSTS(000):$0
Student Data Form
FORMS: OSHA-182
OMB NO: 1218-0173 EXPIRATION DATE: 08/31/2004
RESPS:16,300 HOURS:2,716 COSTS(000):$0
Course Evaluation
FORMS: OSHA-49
OMB NO: 1218-0176 EXPIRATION DATE: 10/31/2004
RESPS:1,444,000 HOURS:3,353,237 COSTS(000):$0
29 CFR Part 1904 Recording and Reporting Occupational Injuries
and Illnesses
FORMS: OSHA-300 OSHA-300A OSHA-301
OMB NO: 1218-0179 EXPIRATION DATE: 10/31/2004
RESPS:418,496 HOURS:103,282 COSTS(000):$23,700
Methylene Chloride 1910.1052
FORMS: NONE
OMB NO: 1218-0180 EXPIRATION DATE: 03/31/2004
RESPS:1,569,329 HOURS:12,719,062 COSTS(000):$27,362
Bloodborne Pathogens Standard (29 CFR 1910.1030)
FORMS: NONE
OMB NO: 1218-0183 EXPIRATION DATE: 09/30/2003
RESPS:3,962 HOURS:1,609 COSTS(000):$80
4,4'-Methylenedianline (MDA) Construction 29 CFR 1926.60
FORMS: NONE
OMB NO: 1218-0184 EXPIRATION DATE: 09/30/2003
RESPS:785 HOURS:394 COSTS(000):$26
4,4'-Methylenedianline (MDA) General Industry 1910.1050
FORMS: NONE
OMB NO: 1218-0185 EXPIRATION DATE: 12/31/2005
RESPS:394,889 HOURS:121,344 COSTS(000):$6,191
Cadmium in General Industry (29 CFR 1910.1027)
FORMS: NONE
OMB NO: 1218-0186 EXPIRATION DATE: 12/31/2005
RESPS:376,889 HOURS:39,331 COSTS(000):$2,237
Cadmium in Construction (29 CFR 1926.1127)
FORMS: NONE
OMB NO: 1218-0189 EXPIRATION DATE: 12/31/2005
RESPS:5,782,074 HOURS:1,560,718 COSTS(000):$69,083
Lead in Construction 1926.62
FORMS: NONE
OMB NO: 1218-0190 EXPIRATION DATE: 09/30/2003
RESPS:515,094 HOURS:34,496 COSTS(000):$0
Electrical Protective Equipment (1910.137), and Electric Power
Generation, Transmission, and Distribution (1910.269) Standard
FORMS: NONE
OMB NO: 1218-0195 EXPIRATION DATE: 12/31/2005
RESPS:2,470 HOURS:1,426 COSTS(000):$34
Asbestos in Shipyards 1915.1001
FORMS: NONE
OMB NO: 1218-0196 EXPIRATION DATE: 10/31/2005
RESPS:149,670 HOURS:36,688 COSTS(000):$0
Longshoring and Marine Terminal Operations (29 CFR Parts 1917
and 1918)
FORMS: NONE
OMB NO: 1218-0197 EXPIRATION DATE: 02/29/2004
RESPS:100,000 HOURS:771,166 COSTS(000):$0
Construction Fall Protection Plans and Records
FORMS: NONE
OMB NO: 1218-0198 EXPIRATION DATE: 09/30/2004
RESPS:166,040 HOURS:22,730 COSTS(000):$0
Logging Operations (29 CFR 1910.266)
FORMS: NONE
OMB NO: 1218-0199 EXPIRATION DATE: 06/30/2003
RESPS:10,100 HOURS:33,837 COSTS(000):$0
Standard on Walking-Working Surfaces (29 CFR Part 1910, Subpart
D)
FORMS: NONE
OMB NO: 1218-0200 EXPIRATION DATE: 03/31/2006
RESPS:7,398,312 HOURS:50,980,689 COSTS(000):$0
Process Safety Management of Highly Hazardous Chemicals (PSM)
(29 CFR 1910.119)
FORMS: NONE
OMB NO: 1218-0202 EXPIRATION DATE: 12/31/2005
RESPS:203,851 HOURS:1,404,369 COSTS(000):$4,668
Hazardous Waste Operations and Emergency Response (Hazwoper) (29
CFR 1910.120)
FORMS: NONE
OMB NO: 1218-0203 EXPIRATION DATE: 10/31/2005
RESPS:9,281,633 HOURS:1,666,663 COSTS(000):$0
Permit-Required Confined Spaces (29 CFR 1910.146)
FORMS: NONE
OMB NO: 1218-0205 EXPIRATION DATE: 05/31/2003
RESPS:5,965,572 HOURS:1,834,279 COSTS(000):$0
Personal Protection Equipment for General Industry (29 CFR
1910.132)
FORMS: NONE
OMB NO: 1218-0206 EXPIRATION DATE: 10/31/2004
RESPS:1,774,166 HOURS:136,781 COSTS(000):$0
Grain Handling Facilities (29 CFR 1910.272)
FORMS: NONE
OMB NO: 1218-0207 EXPIRATION DATE: 08/31/2004
RESPS:101,492 HOURS:8,119 COSTS(000):$0
Welding, Cutting and Brazing (29 CFR part 1910, Subpart Q)
FORMS: NONE
OMB NO: 1218-0208 EXPIRATION DATE: 09/30/2004
RESPS:330 HOURS:2,500 COSTS(000):$0
Storage and Handling of Anhydrous Ammonia (29 CFR 1910.111(b)(3)
and (b)(4))
FORMS: NONE
OMB NO: 1218-0209 EXPIRATION DATE: 04/30/2003
RESPS:100,175 HOURS:48,088 COSTS(000):$0
OSHA Data Initiative (ODI)
FORMS: OSHA-196A OSHA-196B
OMB NO: 1218-0215 EXPIRATION DATE: 05/31/2003
RESPS:87,000 HOURS:2,255 COSTS(000):$0
Personal Protective Equipment (PPE) for Shipyard Employment (29
CFR Part 1915)
FORMS: NONE
OMB NO: 1218-0216 EXPIRATION DATE: 12/31/2003
RESPS:60 HOURS:3 COSTS(000):$0
Manfacturer's Certification of Modifications Made to
Construction Aerial Lifts
FORMS: NONE
OMB NO: 1218-0217 EXPIRATION DATE: 10/31/2005
RESPS:160 HOURS:1,280 COSTS(000):$1,704
Blasting Operations (29 CFR 1926.900(k)(3)(i))
FORMS: NONE
OMB NO: 1218-0218 EXPIRATION DATE: 05/31/2004
RESPS:1,170,733 HOURS:131,708 COSTS(000):$11,941
The Hydrostatic Testing Provision of the Standard on Portable
Fire Extinguishers (29 CFR 1910.157(f)(16))
FORMS: NONE
OMB NO: 1218-0219 EXPIRATION DATE: 09/30/2005
RESPS:8 HOURS:1 COSTS(000):$0
Servicing Multi-Piece and Single Piece Rim Wheels (29 CFR
1910.177(d)(3)(iv))
FORMS: NONE
OMB NO: 1218-0220 EXPIRATION DATE: 09/30/2005
RESPS:16,320 HOURS:4,416 COSTS(000):$0
Shipyard Employment Standards (29 CFR 1915.113(b)(1) and
1915.172(d))
FORMS: NONE
OMB NO: 1218-0221 EXPIRATION DATE: 05/31/2004
RESPS:462,040 HOURS:174,040 COSTS(000):$0
Crawler, Locomotive, and Truck Cranes Standard (29 CFR 1910.180)
FORMS: NONE
OMB NO: 1218-0222 EXPIRATION DATE: 04/30/2004
RESPS:115,000 HOURS:28,550 COSTS(000):$0
Derricks (29 CFR 1910.181)
FORMS: NONE
OMB NO: 1218-0223 EXPIRATION DATE: 08/31/2005
RESPS:155,838 HOURS:21,517 COSTS(000):$0
Slings (29 CFR 1910.184)
FORMS: NONE
OMB NO: 1218-0224 EXPIRATION DATE: 05/31/2004
RESPS:720,105 HOURS:360,140 COSTS(000):$0
Overhead and Gantry Cranes Standard (29 CFR 1910.179(b)(3),
(b)(5), (j)(2)(iii), (j)(2)(iv), (k)(2), (m)(1), and (m)(2))
FORMS: NONE
OMB NO: 1218-0225 EXPIRATION DATE: 09/30/2005
RESPS:107,138 HOURS:7,487 COSTS(000):$0
Telecommunications, Training Certification (29 CFR 1910.268(c))
FORMS: NONE
OMB NO: 1218-0226 EXPIRATION DATE: 08/31/2004
RESPS:36,000 HOURS:41,400 COSTS(000):$0
Standard on Manlifts (29 CFR 1910.68(e)(3))
FORMS: NONE
OMB NO: 1218-0227 EXPIRATION DATE: 10/31/2005
RESPS:52 HOURS:9 COSTS(000):$0
Trucks Used Underground to Transport Explosives (29 CFR 1926.903
(e) -- Inspection Certifications
FORMS: NONE
OMB NO: 1218-0228 EXPIRATION DATE: 08/31/2005
RESPS:1,440,400 HOURS:244,868 COSTS(000):$0
Forging Machines, Inspection Certification Records (29 CFR
1910.218(a)(2)(i) and (a)(2)(ii))
FORMS: NONE
OMB NO: 1218-0229 EXPIRATION DATE: 05/31/2004
RESPS:9,971,000 HOURS:1,372,930 COSTS(000):$0
Mechanical Power Presses (29 CFR 1910.217(e)(1)(i) and
(e)(1)(ii))
FORMS: NONE
OMB NO: 1218-0230 EXPIRATION DATE: 10/31/2005
RESPS:900 HOURS:45 COSTS(000):$0
Vehicle-Mounted Elevating and Rotating Work Platforms (Aerial
Lifts) (29 CFR 1910.67(b)(2))
FORMS: NONE
OMB NO: 1218-0231 EXPIRATION DATE: 04/30/2004
RESPS:130,095 HOURS:30,271 COSTS(000):$0
Material Hoists, Personnel Hoists, and Elevators; Posting
Requirements, Text and Inspections 1926.552 (a)(2), (b)(1)(i),
(c)(10), and (c)(15)
FORMS: NONE
OMB NO: 1218-0232 EXPIRATION DATE: 05/31/2004
RESPS:254,856 HOURS:169,200 COSTS(000):$0
Crawler, Truck and Locomotive Cranes (29 CFR 1926.550(b)(2))
FORMS: NONE
OMB NO: 1218-0233 EXPIRATION DATE: 05/31/2004
RESPS:301,619 HOURS:56,236 COSTS(000):$0
Rigging Equipment for Material Handling (29 CFR 1926.251(b)(1),
(b)(6)(i), (c)(15)(ii), (e)(1)(i), (ii), (iii), and (f)(2)
FORMS: NONE
OMB NO: 1218-0236 EXPIRATION DATE: 06/30/2004
RESPS:250 HOURS:250 COSTS(000):$0
Regulations, 29 CFR Part 24, Procedures for Handling of
Discrimination Complaints Under Federal Employee Protection
Statutes
FORMS: NONE
OMB NO: 1218-0237 EXPIRATION DATE: 05/31/2004
RESPS:1 HOURS:1 COSTS(000):$0
Dipping and Coating Operations (Dip Tanks)
FORMS: NONE
OMB NO: 1218-0238 EXPIRATION DATE: 05/31/2004
RESPS:132,000 HOURS:66,000 COSTS(000):$19,008
Portable Fire Extinguishers (Annual Maintenance Certification
Record) (29 CFR 1910.157(e)(3))
FORMS: NONE
OMB NO: 1218-0239 EXPIRATION DATE: 10/31/2004
RESPS:1,107 HOURS:48,443 COSTS(000):$0
Voluntary Protection Program Application Information
FORMS: NONE
OMB NO: 1218-0241 EXPIRATION DATE: 02/28/2005
RESPS:252,975 HOURS:30,786 COSTS(000):$0
Subpart R Steel Erection 29 CFR 1926.750 through 1926.761
FORMS: NONE
OMB NO: 1218-0242 EXPIRATION DATE: 01/31/2005
RESPS:1,423,368 HOURS:949,505 COSTS(000):$210
Powered Industrial Trucks (29 CFR 1910.178)
FORMS: NONE
OMB NO: 1218-0244 EXPIRATION DATE: 01/31/2006
RESPS:4,410 HOURS:49,254 COSTS(000):$0
OSHA Strategic Partnership Program for Worker Safey and Health
FORMS: NONE
OMB NO: 1218-0246 EXPIRATION DATE: 03/31/2004
RESPS:5,340,499 HOURS:1,236,764 COSTS(000):$0
Bloodborne Pathogens Standard (Needlestick Safety and Prevention
Act)
FORMS: NONE
OMB NO: 1218-0247 EXPIRATION DATE: 11/30/2005
RESPS:979 HOURS:8,522 COSTS(000):$0
Occupational Safety and Health State Plan Information
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
96 723,577,910 111,500,253 $612,449
Mine Safety and Health Administration
OMB NO: 1219-0001 EXPIRATION DATE: 04/30/2004
RESPS:2,886 HOURS:13,297 COSTS(000):$410
Certificate of Electrical Training (30 CFR 75.153(a)(2) and
77.103(a)(2)
FORMS: MSHA-5000-1
OMB NO: 1219-0003 EXPIRATION DATE: 10/31/2004
RESPS:100 HOURS:800 COSTS(000):$0
Radiation Sampling and Exposure Records (30 CFR 57.5037, and
57.5040)
FORMS: 4000-9
OMB NO: 1219-0004 EXPIRATION DATE: 05/31/2003
RESPS:3,517 HOURS:5,967 COSTS(000):$6
Roof Control Plans (30 CFR 75.220, 75.221, and 75.223)
FORMS: NONE
OMB NO: 1219-0006 EXPIRATION DATE: 11/30/2005
RESPS:86,158 HOURS:41,155 COSTS(000):$27
Quarterly Mine Employment and Coal Production Report (30 CFR
50.30(a))
FORMS: MSHA-7000-2
OMB NO: 1219-0007 EXPIRATION DATE: 12/31/2004
RESPS:58,224 HOURS:49,823 COSTS(000):$13
Mine Accident, Injury & Illness Report (30 CFR 50.10; 50.11, &
50.20(a))
FORMS: MSHA-7000-1
OMB NO: 1219-0008 EXPIRATION DATE: 02/28/2005
RESPS:6,625 HOURS:1,735 COSTS(000):$2
Notification of Legal Identity (30 CFR Section 41.10, 41.11,
41.12, and 41.20
FORMS: MSHA-2000-7
OMB NO: 1219-0009 EXPIRATION DATE: 11/30/2004
RESPS:1,294 HOURS:10,352 COSTS(000):$2
Training Plan Regulations (30 CFR 48.3 and 48.23)
FORMS: NONE
OMB NO: 1219-0011 EXPIRATION DATE: 04/30/2003
RESPS:58,162 HOURS:42,454 COSTS(000):$3,128
Mine Operator Dust Data Cards -- 70/71/90.209; 70/71/90.201(c);
70/71/90.202(b); 70/7l/90.220(a); 7l/90.300; and 70/90.301(d)
FORMS: NONE
OMB NO: 1219-0012 EXPIRATION DATE: 06/30/2003
RESPS:7 HOURS:11 COSTS(000):$0
Main Fan Maintenance Record
FORMS: NONE
OMB NO: 1219-0014 EXPIRATION DATE: 09/30/2004
RESPS:651 HOURS:130 COSTS(000):$0
Hazardous Conditions Complaints (30 CFR 43.4 and 43.7)
FORMS: NONE
OMB NO: 1219-0015 EXPIRATION DATE: 03/31/2005
RESPS:12,428 HOURS:95,753 COSTS(000):$0
Refuse Piles and Impounding Structures, Recordkeeping and
Reporting Requirements (30 CFR 77.215(j); 77.215-2 thur 4;
77.216-2 through 5)
FORMS: NONE
OMB NO: 1219-0016 EXPIRATION DATE: 09/30/2004
RESPS:284 HOURS:6,816 COSTS(000):$0
Mine Ventilation System Plan (57.8520)
FORMS: NONE
OMB NO: 1219-0019 EXPIRATION DATE: 09/30/2004
RESPS:48 HOURS:960 COSTS(000):$1
Slope and Shaft Sinking Plans (30 CFR 77.1900)
FORMS: NONE
OMB NO: 1219-0020 EXPIRATION DATE: 08/31/2004
RESPS:10 HOURS:50 COSTS(000):$0
Operations Under Water (30 CFR 75.1716, 75.1716-1, and 75.1716.3
FORMS: NONE
OMB NO: 1219-0024 EXPIRATION DATE: 10/31/2004
RESPS:546 HOURS:221 COSTS(000):$0
Application for Waiver of Surface Facilities Requirements (30
CFR 71.403, 71.404, 75.1712-4, and 75.1712-5)
FORMS: NONE
OMB NO: 1219-0025 EXPIRATION DATE: 06/30/2004
RESPS:161 HOURS:90 COSTS(000):$1
Application for a Permit to Fire More than 20 Boreholes for the
use of Nonpermissible Blasting Units, Explosive, and Shot-firing
Units
FORMS: NONE
OMB NO: 1219-0026 EXPIRATION DATE: 09/30/2003
RESPS:159 HOURS:1,404 COSTS(000):$0
Ground Control Plan (30 CFR 77.1000 and 77.1000-1)
FORMS: NONE
OMB NO: 1219-0030 EXPIRATION DATE: 12/31/2003
RESPS:2,625 HOURS:1,313 COSTS(000):$2
Main Fan Operation and Inspection (30 CFR 57.22204)
FORMS: NONE
OMB NO: 1219-0034 EXPIRATION DATE: 03/31/2005
RESPS:276,032 HOURS:136,038 COSTS(000):$209
Records of Tests and Examinations of Personnel Hoisting Equipment
FORMS: NONE
OMB NO: 1219-0039 EXPIRATION DATE: 01/31/2004
RESPS:2 HOURS:2 COSTS(000):$0
Gamma Radiation Exposure Records
FORMS: NONE
OMB NO: 1219-0040 EXPIRATION DATE: 02/28/2006
RESPS:99,398 HOURS:13,250 COSTS(000):$175
Independent Contractor Register
FORMS: NONE
OMB NO: 1219-0041 EXPIRATION DATE: 08/31/2004
RESPS:188 HOURS:94 COSTS(000):$0
Program to Prevent Smoking in Hazardous Areas (30 CFR 75.1702)
FORMS: NONE
OMB NO: 1219-0042 EXPIRATION DATE: 10/31/2004
RESPS:108 HOURS:81 COSTS(000):$0
representative of Miners (30 CFR 40.3, 40.4, and 40.5)
FORMS: NONE
OMB NO: 1219-0043 EXPIRATION DATE: 07/31/2003
RESPS:1,687 HOURS:191 COSTS(000):$1
Identification of Independent Contractors (30 CFR 45.3)
FORMS: NONE
OMB NO: 1219-0044 EXPIRATION DATE: 11/30/2004
RESPS:236,632 HOURS:118,268 COSTS(000):$0
Record of Results of Examinations of Self-Rescuers, Underground
Coal Mines -- 30 CFR 75.1714-3(e)
FORMS: NONE
OMB NO: 1219-0046 EXPIRATION DATE: 11/30/2004
RESPS:568 HOURS:4,544 COSTS(000):$2
Escape and Evacuation Plans (30 CFR 57.11053)
FORMS: NONE
OMB NO: 1219-0048 EXPIRATION DATE: 02/28/2005
RESPS:5,530 HOURS:2,235 COSTS(000):$156
Respirator Program Records (30 CFR 56.5005 and 57.5005)
FORMS: NONE
OMB NO: 1219-0049 EXPIRATION DATE: 03/31/2005
RESPS:235 HOURS:8 COSTS(000):$72
Hoist Operators' Physical Fitness
FORMS: NONE
OMB NO: 1219-0051 EXPIRATION DATE: 11/30/2003
RESPS:59 HOURS:263 COSTS(000):$0
Fire Protection, Escape and Evacuation Plan -- 30 CFR 77.1101
FORMS: NONE
OMB NO: 1219-0054 EXPIRATION DATE: 09/30/2003
RESPS:398,339 HOURS:89,263 COSTS(000):$2
Fire Protection for Underground Coal Mines (30 CFR Part 75,
Subpart L)
FORMS: NONE
OMB NO: 1219-0065 EXPIRATION DATE: 10/31/2003
RESPS:174 HOURS:5,400 COSTS(000):$79
Petitions for Modification - Pertains to All Mines (30 CFR 44,9,
44.10, and 44.11)
FORMS: NONE
OMB NO: 1219-0066 EXPIRATION DATE: 07/31/2005
RESPS:592 HOURS:2,926 COSTS(000):$447
Permissible Equipment Testing
FORMS: NONE
OMB NO: 1219-0067 EXPIRATION DATE: 05/31/2005
RESPS:1,591,866 HOURS:1,011,034 COSTS(000):$30,000
Examinations and Tests of Electrical Equipment (30 CFR 75.512,
75.703(d)(II), 77.502, 75.800, 77.900, 75.1001-1(c), and 75.351)
FORMS: NONE
OMB NO: 1219-0069 EXPIRATION DATE: 05/31/2003
RESPS:611 HOURS:213 COSTS(000):$0
Qualification and Certification Program (30 CFR 75.100; 75.155;
77.100; and 77.105)
FORMS: 5000-4 5000-7
OMB NO: 1219-0070 EXPIRATION DATE: 11/30/2004
RESPS:105,050 HOURS:8,393 COSTS(000):$210
Certificate of Training (30 CFR 48.9 and 48.29)
FORMS: 5000-23
OMB NO: 1219-0073 EXPIRATION DATE: 03/31/2006
RESPS:1,645 HOURS:23,928 COSTS(000):$23,803
Record of Mine Closures, Opening and Reopening of Mines
FORMS: NONE
OMB NO: 1219-0078 EXPIRATION DATE: 01/31/2004
RESPS:46,282 HOURS:24,975 COSTS(000):$468
Mine Rescue Teams; Arrangements for Emergency Medical
Assistance; and Arrangements for Transportation of Injured
Persons
FORMS: 5000-3
OMB NO: 1219-0082 EXPIRATION DATE: 11/30/2003
RESPS:11,858 HOURS:14,823 COSTS(000):$0
Records of Preshift and Onshift Inspections of Slope and Shaft
Areas (30 CFR 77.1901)
FORMS: NONE
OMB NO: 1219-0083 EXPIRATION DATE: 12/31/2003
RESPS:411,885 HOURS:617,828 COSTS(000):$0
Record of Examinations for Hazardous Conditions (30 CFR 77.1713)
FORMS: NONE
OMB NO: 1219-0088 EXPIRATION DATE: 03/31/2004
RESPS:2,262,566 HOURS:2,725,770 COSTS(000):$194
Ventilation Plans, Tests, and Examinations in Underground Coal
Mines (30 CFR 7 70.205(a); 70.211(b); 212(b); .216(a); 75.310;
312; 342; 351; 360; 361; 362; 363; 364; 370; and 382
FORMS: NONE
OMB NO: 1219-0089 EXPIRATION DATE: 09/30/2004
RESPS:18,203,818 HOURS:1,224,406 COSTS(000):$0
Safety Defects; Examination, Correction and Records (30 CFR
56/57.13015; 13030; 14100; and 56/57.18002)
FORMS: NONE
OMB NO: 1219-0092 EXPIRATION DATE: 04/30/2003
RESPS:2,070 HOURS:259 COSTS(000):$1
Notification of Commencement of Operations and Closing of Mines
(30 CFR 56.1000 and 57.1000)
FORMS: NONE
OMB NO: 1219-0095 EXPIRATION DATE: 12/31/2003
RESPS:7 HOURS:7 COSTS(000):$0
Explosive Materials and Blasting Units (30 CFR 57.22606)
FORMS: NONE
OMB NO: 1219-0096 EXPIRATION DATE: 08/31/2003
RESPS:1 HOURS:160 COSTS(000):$0
Underground Retorts (30 CFR 57.22401)
FORMS: NONE
OMB NO: 1219-0097 EXPIRATION DATE: 02/28/2005
RESPS:2 HOURS:24 COSTS(000):$0
Rock Burst Control Plan (Pertains to Underground Metal/Nonmetal
Mines (30 CFR 57.3461)
FORMS: NONE
OMB NO: 1219-0100 EXPIRATION DATE: 08/31/2003
RESPS:307 HOURS:565 COSTS(000):$42
Product Testing by Applicant or Third Part (30 CFR Part 7,
Subparts A through F, and J through K)
FORMS: NONE
OMB NO: 1219-0101 EXPIRATION DATE: 11/30/2003
RESPS:2 HOURS:16 COSTS(000):$0
Applications for Approval of Sanitary Toilet Facilities (30 CFR
71.500 and 75.1712-6)
FORMS: NONE
OMB NO: 1219-0103 EXPIRATION DATE: 08/31/2003
RESPS:372 HOURS:31 COSTS(000):$0
Notification of Methane Detected in Mine Atmosphere (30 CFR
57.220004(c); 57.22229; 57.22230; 57.22231, and 57.22239)
FORMS: NONE
OMB NO: 1219-0116 EXPIRATION DATE: 04/30/2005
RESPS:24,762 HOURS:5,736 COSTS(000):$0
High-Voltage Longwall Equipment Standards for Underground Coal
Mines (75.820(b), 75.820(e), and 75.821(d))
FORMS: NONE
OMB NO: 1219-0119 EXPIRATION DATE: 03/31/2006
RESPS:101,944 HOURS:58,265 COSTS(000):$377
Approval, Exhaust Gas Monitoring, and Safety Requirements for
the Use of Diesel-Powered Equipment in Underground Coal Mines
FORMS: NONE
OMB NO: 1219-0120 EXPIRATION DATE: 01/31/2006
RESPS:821,843 HOURS:101,852 COSTS(000):$4,151
Noise Exposure Assessment; Audometric Testing Evaluaiton, and
Records and Training in All Mines
FORMS: NONE
OMB NO: 1219-0121 EXPIRATION DATE: 08/31/2003
RESPS:8,616 HOURS:431 COSTS(000):$0
Safety Standard for Roof Bolts in Metal and Nonmetal Mines and
Underground Coal Mines (30 CFR 56/57.3203(a), and 75.204(a))
FORMS: NONE
OMB NO: 1219-0124 EXPIRATION DATE: 05/31/2004
RESPS:5,758 HOURS:1,697 COSTS(000):$171
Diesel Particulate Matter Exposure of Underground Coal Miners.
(30 CFR 75.1915, 72.503, 72.510, 72.520, 72.500, Part 7 of Part
36)
FORMS: NONE
OMB NO: 1219-0125 EXPIRATION DATE: 02/28/2005
RESPS:102,000 HOURS:78,001 COSTS(000):$0
Safety Standards for Underground Coal Mine Ventilation (30 CFR
75.360(a)(1) and 75.360(f))
FORMS: NONE
OMB NO: 1219-0127 EXPIRATION DATE: 04/30/2005
RESPS:11,825 HOURS:20,888 COSTS(000):$0
Records of All Certified and Qualified Persons; and Man Hoist
Operators Physicial Fitness (30 CFR 75.155, 75.159 - 161,
77.105, 77.107, 77.107-1, 77.106)
FORMS: NONE
OMB NO: 1219-0131 EXPIRATION DATE: 02/28/2006
RESPS:167,340 HOURS:263,274 COSTS(000):$521
Training Plans, New Miner Training, Newly hired Experienced
Miner Training
FORMS: NONE
OMB NO: 1219-0133 EXPIRATION DATE: 08/31/2005
RESPS:940,758 HOURS:648,638 COSTS(000):$552
Hazard Communication - 30 CFR Part 47 - Final Rule
FORMS: NONE
OMB NO: 1219-0135 EXPIRATION DATE: 09/30/2004
RESPS:152,565 HOURS:6,047 COSTS(000):$781
Health Standards for Diesel Particulates (Underground Metal and
Nonmetal Mines) 57.5060; 5062; 5066; 5071; and 5075
FORMS: NONE
OMB NO: 1219-0137 EXPIRATION DATE: 06/30/2003
RESPS:55,908 HOURS:5,010 COSTS(000):$0
Emergency Evacuations and Mine Emergency Evaluation and Fire-
Fighting Program of Instructon
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
59 26,285,090 7,487,165 $66,006
Bureau of Labor Statistics
OMB NO: 1220-0008 EXPIRATION DATE: 05/31/2005
RESPS:1,266,340 HOURS:390,680 COSTS(000):$0
Producer Price Index Survey
FORMS: BLS-473P BLS-1810A A1 B C C1 E
OMB NO: 1220-0011 EXPIRATION DATE: 02/28/2005
RESPS:4,482,000 HOURS:508,180 COSTS(000):$0
Report on Employment, Payroll, and Hours
FORMS: BLS-790
OMB NO: 1220-0012 EXPIRATION DATE: 09/30/2004
RESPS:212 HOURS:954,720 COSTS(000):$0
Employment, Wages, and Contributions Program - ES-202
FORMS: NONE
OMB NO: 1220-0017 EXPIRATION DATE: 12/31/2005
RESPS:87,300 HOURS:139,680 COSTS(000):$0
Local Area Unemployment Statistics Program Manual
FORMS: BLS-3040 LAUS-8 LAUS-15 LAUS-16
OMB NO: 1220-0025 EXPIRATION DATE: 09/30/2003
RESPS:40,240 HOURS:23,379 COSTS(000):$0
International Price Program (IPP) U.S. Export Price Indexes
FORMS: BLS-3007D BLS-3008
OMB NO: 1220-0026 EXPIRATION DATE: 09/30/2003
RESPS:40,240 HOURS:24,246 COSTS(000):$0
International Price Program/U.S. Import Product Information
FORMS: BLS-3007D BLS-3008
OMB NO: 1220-0032 EXPIRATION DATE: 10/31/2004
RESPS:2,272,998 HOURS:206,903 COSTS(000):$0
Annual Refiling Survey (ARS) [formerly called the Standard
Industrial Classification (SIC) forms]
FORMS: BLS-3023-NVS BLS-3023-NVM BLS-3023-NCA
OMB NO: 1220-0039 EXPIRATION DATE: 07/31/2005
RESPS:362,804 HOURS:97,792 COSTS(000):$0
Consumer Price Index Commodities and Services Survey
FORMS: BLS-3400 BLS-3400-A.2 BLS-3400-B BLS-3400-C BLS-3401
OMB NO: 1220-0042 EXPIRATION DATE: 08/31/2004
RESPS:317,492 HOURS:238,119 COSTS(000):$0
Report on Occupational Employment
FORMS: BLS-2877
OMB NO: 1220-0044 EXPIRATION DATE: 12/31/2005
RESPS:57,280 HOURS:10,501 COSTS(000):$0
Point of Purchase Survey
FORMS: NONE
OMB NO: 1220-0045 EXPIRATION DATE: 10/31/2004
RESPS:230,000 HOURS:327,666 COSTS(000):$0
Survey of Occupational Injuries and Illnesses
FORMS: BLS-9300
OMB NO: 1220-0050 EXPIRATION DATE: 10/31/2005
RESPS:80,652 HOURS:95,352 COSTS(000):$0
The Consumer Expenditure Surveys: The Quarterly Interview and
the Diary
FORMS: CE-801 CE-802 CE-880 CE-880N
OMB NO: 1220-0079 EXPIRATION DATE: 08/31/2003
RESPS:860 HOURS:793 COSTS(000):$0
Labor Market Information (LMI) Cooperative Agreement
FORMS: BLS-LMI-1A 1B 2A 2B
OMB NO: 1220-0090 EXPIRATION DATE: 11/30/2005
RESPS:23,848 HOURS:81,547 COSTS(000):$0
Mass Layoff Statistics Program
FORMS: NONE
OMB NO: 1220-0100 EXPIRATION DATE: 08/31/2005
RESPS:684,000 HOURS:79,800 COSTS(000):$0
Current Population Survey (CPS) Basic Labor Force
FORMS: NONE
OMB NO: 1220-0110 EXPIRATION DATE: 12/31/2003
RESPS:7,345 HOURS:7,904 COSTS(000):$0
National Longitudinal Survey of Women
FORMS: NLS-A033 NLS-A033(L) NLS-A035.1 NSL-A035.2 NLS-A037.1 NLS-A037.2
NLS-A0336
OMB NO: 1220-0133 EXPIRATION DATE: 02/28/2005
RESPS:27,500 HOURS:5,000 COSTS(000):$0
Census of Fatal Occupational Injuries
FORMS: BLS-CFOI-1
OMB NO: 1220-0134 EXPIRATION DATE: 02/29/2004
RESPS:459,068 HOURS:169,855 COSTS(000):$0
Multiple Workshie Report and the Report of Federal Employment
and Wages
FORMS: BLS-3020 BLS-3021
OMB NO: 1220-0141 EXPIRATION DATE: 01/31/2006
RESPS:4,000 HOURS:4,000 COSTS(000):$0
Cognitive and Psychological Research
FORMS: NONE
OMB NO: 1220-0149 EXPIRATION DATE: 10/31/2003
RESPS:285 HOURS:342 COSTS(000):$0
BLS/OSHS Federal/State Cooperative Agreement (Application
Package)
FORMS: BLS-OSHS1 BLS-OSHS2
OMB NO: 1220-0157 EXPIRATION DATE: 09/30/2004
RESPS:17,151 HOURS:10,972 COSTS(000):$0
National Longitudinal Survey of Youth 1997
FORMS: NONE
OMB NO: 1220-0163 EXPIRATION DATE: 08/31/2003
RESPS:163,394 HOURS:19,299 COSTS(000):$0
Consumer Price Index (CPI) Housing Survey (CADC)
FORMS: NONE
OMB NO: 1220-0164 EXPIRATION DATE: 10/31/2004
RESPS:70,886 HOURS:66,593 COSTS(000):$0
National Compensation Survey
FORMS: NONE
OMB NO: 1220-0168 EXPIRATION DATE: 09/30/2003
RESPS:23,890 HOURS:15,762 COSTS(000):$0
General Inquiries to State Agency Contacts
FORMS: NONE
OMB NO: 1220-0170 EXPIRATION DATE: 04/30/2003
RESPS:111,440 HOURS:24,765 COSTS(000):$0
Job Openings and Labor Turnover Survey (JOLTS)
FORMS: BLS-1411-C1 BLS-1411-C2 BLS-1411-C3 BLS-1411-TD1 BLS-1411-TD2
BLS-1411-TD3 BLS-1411-FM2 BLS-1411-FM3
OMB NO: 1220-0175 EXPIRATION DATE: 10/31/2004
RESPS:28,000 HOURS:9,333 COSTS(000):$0
American Time Use Survey (ATUS)
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
26 10,859,225 3,513,183 $0
Departmental Management
OMB NO: 1225-0013 EXPIRATION DATE: 02/28/2005
RESPS:10 HOURS:50 COSTS(000):$0
Equal Access to Justice Act
FORMS: NONE
OMB NO: 1225-0030 EXPIRATION DATE: 09/30/2003
RESPS:7,000 HOURS:12,250 COSTS(000):$0
Disclosure of Information to Credit Reporting Agencies;
Administrative Offset, Interest, Penalties and Administrative
Costs
FORMS: NONE
OMB NO: 1225-0038 EXPIRATION DATE: 11/30/2003
RESPS:300 HOURS:375 COSTS(000):$0
Salary Offset
FORMS: NONE
OMB NO: 1225-0044 EXPIRATION DATE: 11/30/2003
RESPS:5,500 HOURS:5,840 COSTS(000):$0
National Agricultural Workers Survey
FORMS: NONE
OMB NO: 1225-0059 EXPIRATION DATE: 06/30/2003
RESPS:63,750 HOURS:13,500 COSTS(000):$0
Customer Satisfaction Surveys and Conference Evaluations Generic
Clearance
FORMS: NONE
OMB NO: 1225-0072 EXPIRATION DATE: 11/30/2003
RESPS:3,000 HOURS:250 COSTS(000):$0
Applicant Background Questionnaire
FORMS: NONE
OMB NO: 1225-0080 EXPIRATION DATE: 12/31/2005
RESPS:110 HOURS:588 COSTS(000):$0
Women in Apprenticeship and Nontraditional Occupations (WANTO)
Act Grant Application and Reporting Requirements
FORMS: NONE
OMB NO: 1225-0082 EXPIRATION DATE: 06/30/2003
RESPS:1,000 HOURS:100 COSTS(000):$0
The National Survey of Attitudes Reguarding Comp Time and
Balancing Work and Family
FORMS: NONE
OMB NO: 1225-0083 EXPIRATION DATE: 02/28/2006
RESPS:1,000 HOURS:80 COSTS(000):$0
Survey on Ensuring Equal Opportunity for Applicants
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
9 81,670 33,033 $0
Office of Disability Employment Policy
OMB NO: 1230-0002 EXPIRATION DATE: 12/31/2005
RESPS:100 HOURS:1,000 COSTS(000):$0
Solicitation of Nominations for the Department of Labor's New
Freedom Initiative Award
FORMS: NONE
OMB NO: 1230-0003 EXPIRATION DATE: 02/28/2006
RESPS:14,100 HOURS:4,655 COSTS(000):$0
Employment Assistance Referral Network (EARN) Employer and
Provider Enrollment Forms, Employer Job Posting Form, and
Employer and Provider Surveys
FORMS: EARN-1 EARN-2
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
2 14,200 5,655 $0
Office of the Secretary
OMB NO: 1290-0002 EXPIRATION DATE: 08/31/2004
RESPS:6,000 HOURS:540 COSTS(000):$0
Small Business Program Information Management System
FORMS: NONE
OMB NO: 1290-0003 EXPIRATION DATE: 12/31/2005
RESPS:3,719,308 HOURS:111,579 COSTS(000):$0
Information Collection Plan for GovBenefits Online
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
2 3,725,308 112,119 $0
Office of the Assistant Secretary for Veterans' Employment and Training
OMB NO: 1293-0002 EXPIRATION DATE: 01/31/2004
RESPS:1,500 HOURS:375 COSTS(000):$0
Eligibility Data Form: Uniformed Services and Reemployment
Rights Act and Veteran's Preference
FORMS: USERRA/VP-1010
OMB NO: 1293-0005 EXPIRATION DATE: 04/30/2003
RESPS:194,580 HOURS:145,935 COSTS(000):$0
Federal Contractor Veterans' Employment Report - VETS-100
FORMS: VETS-100
OMB NO: 1293-0009 EXPIRATION DATE: 09/30/2004
RESPS:5,065 HOURS:19,465 COSTS(000):$0
VETS 300 Cost Accounting Report and Manager's Report
FORMS: VETS-300
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
3 201,145 165,775 $0
AGENCY TOTALS:
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
412 1,354,433,272 159,835,553 $1,796,830
Department of State
Administration of Foreign Affairs
OMB NO: 1405-0002 EXPIRATION DATE: 07/31/2005
RESPS:5,000 HOURS:10,000 COSTS(000):$3,000
Statement of Registration
FORMS: DS-2032
OMB NO: 1405-0003 EXPIRATION DATE: 07/31/2005
RESPS:30,000 HOURS:30,000 COSTS(000):$0
Application/License for permanent export of unclassified defense
articles and related unclassified technical data
FORMS: DSP-5 DSP-5(WEBBASED)
OMB NO: 1405-0004 EXPIRATION DATE: 03/31/2005
RESPS:8,411,550 HOURS:2,803,850 COSTS(000):$720,500
Application for Passport/Registration
FORMS: DS-11
OMB NO: 1405-0007 EXPIRATION DATE: 12/31/2005
RESPS:230,912 HOURS:19,243 COSTS(000):$2,093
Passport Amendment/Validation Application
FORMS: DS-19
OMB NO: 1405-0008 EXPIRATION DATE: 04/30/2003
RESPS:13,660 HOURS:3,415 COSTS(000):$0
Department of State-Foreign Service Officer Written Examination
Registration
FORMS: DS-1998
OMB NO: 1405-0013 EXPIRATION DATE: 07/31/2005
RESPS:1,000 HOURS:500 COSTS(000):$0
Application/License for temporary import of unclassified defense
articles
FORMS: DSP-61
OMB NO: 1405-0014 EXPIRATION DATE: 12/31/2005
RESPS:75,000 HOURS:6,250 COSTS(000):$0
Statement Regarding A Lost or Stolen Passport
FORMS: DS-64
OMB NO: 1405-0015 EXPIRATION DATE: 05/31/2004
RESPS:750,000 HOURS:1,500,000 COSTS(000):$0
Application for Immigrant Visa and Alien Registration
FORMS: DS-230
OMB NO: 1405-0018 EXPIRATION DATE: 08/31/2004
RESPS:9,600,000 HOURS:9,600,000 COSTS(000):$432,000
Nonimmigrant Visa Application
FORMS: DS-156(PAPER) DS-156(WEBFORM)
OMB NO: 1405-0020 EXPIRATION DATE: 03/31/2005
RESPS:1,462,200 HOURS:365,300 COSTS(000):$125,916
Application for Passport by mail
FORMS: DS-82
OMB NO: 1405-0021 EXPIRATION DATE: 07/31/2005
RESPS:17,000 HOURS:17,000 COSTS(000):$0
Non Transfer and Use Certificate
FORMS: DSP-83
OMB NO: 1405-0022 EXPIRATION DATE: 07/31/2005
RESPS:250 HOURS:250 COSTS(000):$0
Application/License for Permanent/Temporary Export or Temporary
Import of Classified Defense Articles and Classified Technical
Data
FORMS: DSP-85
OMB NO: 1405-0023 EXPIRATION DATE: 07/31/2005
RESPS:2,500 HOURS:2,500 COSTS(000):$0
Application/License for temporary export of unclassified defense
articles
FORMS: DSP-73
OMB NO: 1405-0025 EXPIRATION DATE: 07/31/2005
RESPS:12,000 HOURS:12,000 COSTS(000):$0
Statement of political contributions, fees or commissions in
connection with the sale of defense articles or services
FORMS: NONE
OMB NO: 1405-0031 EXPIRATION DATE: 09/30/2005
RESPS:89 HOURS:45 COSTS(000):$0
Approval of Funding to Support Educational Projects
FORMS: 2061
OMB NO: 1405-0033 EXPIRATION DATE: 01/31/2004
RESPS:190 HOURS:217 COSTS(000):$7
Overseas Schools - Grant Status Report
FORMS: DS-2028
OMB NO: 1405-0036 EXPIRATION DATE: 07/31/2005
RESPS:189 HOURS:284 COSTS(000):$0
Grant Request Automated Submissions Program (GRASP) (Formerly
Overseas Schools Questionnaire)
FORMS: DS-573 DS-574 DS-575 DS-576 DS-577
OMB NO: 1405-0050 EXPIRATION DATE: 02/28/2006
RESPS:2,790 HOURS:225,503 COSTS(000):$283
Department of State Acquisition Regulation (DOSAR)
FORMS: NONE
OMB NO: 1405-0051 EXPIRATION DATE: 07/31/2005
RESPS:2,500 HOURS:1,250 COSTS(000):$0
Authority to export defense articles and services sold under the
foreign military sales (FMS) Program
FORMS: DSP-94
OMB NO: 1405-0060 EXPIRATION DATE: 04/30/2003
RESPS:5,000 HOURS:2,125 COSTS(000):$100
Notification of Appointment of Foreign Government Employees
FORMS: DS-2004
OMB NO: 1405-0061 EXPIRATION DATE: 04/30/2003
RESPS:6,000 HOURS:720 COSTS(000):$0
Notification of Termination of Diplomatic, Consular, and Foreign
Government Employees
FORMS: DS-2008
OMB NO: 1405-0062 EXPIRATION DATE: 04/30/2003
RESPS:2,000 HOURS:850 COSTS(000):$40
Notification of Appointment of Foreign Diplomatic Officer and
Career Consular Officer
FORMS: DS-2003
OMB NO: 1405-0064 EXPIRATION DATE: 04/30/2003
RESPS:200 HOURS:80 COSTS(000):$4
Notification of Appointment of Honorary Consular Officer
FORMS: DS-2005
OMB NO: 1405-0068 EXPIRATION DATE: 09/30/2005
RESPS:12,000 HOURS:12,000 COSTS(000):$0
Medical History and Examination for Foreign Service-For persons
12 years and over Medical History and Examination for Foreign
Service-For children 11 years under
FORMS: DS-1843 DS-1622
OMB NO: 1405-0069 EXPIRATION DATE: 12/31/2005
RESPS:2,916 HOURS:49 COSTS(000):$0
Application for Diplomatic Exemption from Taxes on Utilities
Application for Diplomatic Exemption from Taxes on Gasoline
FORMS: DS-98 DS-99
OMB NO: 1405-0072 EXPIRATION DATE: 03/31/2006
RESPS:1,800 HOURS:9,250 COSTS(000):$0
Diplomatic Motor Vehicles Application for: Vehicle Registration,
Title & Replacement Plates
FORMS: DS-100 DS-101 DS-102 DS-104
OMB NO: 1405-0076 EXPIRATION DATE: 10/31/2003
RESPS:500 HOURS:500 COSTS(000):$0
Application for Assistance Under the Hague Convention on Child
Abduction
FORMS: DS-3013
OMB NO: 1405-0082 EXPIRATION DATE: 05/31/2003
RESPS:500 HOURS:250 COSTS(000):$0
Petition to Classify Special Immigrant Under INA 203(b)(4) as an
employee or former employee of the U.S. Government
FORMS: DS-1884
OMB NO: 1405-0088 EXPIRATION DATE: 12/31/2005
RESPS:120,000 HOURS:10,000 COSTS(000):$0
Affidavit of Identifying Witness
FORMS: DS-71
OMB NO: 1405-0089 EXPIRATION DATE: 04/30/2003
RESPS:5,000 HOURS:600 COSTS(000):$0
Notification of Change Identification Card Request
FORMS: DS-2006
OMB NO: 1405-0090 EXPIRATION DATE: 04/30/2003
RESPS:7,000 HOURS:840 COSTS(000):$140
Notification of Dependents of Diplomatic, Consular, and Foreign
Government Employees (Continuation Sheet)
FORMS: DS-2007
OMB NO: 1405-0091 EXPIRATION DATE: 05/31/2004
RESPS:1,000 HOURS:500 COSTS(000):$0
Application to Determine Returning Resident Status
FORMS: DS-117
OMB NO: 1405-0092 EXPIRATION DATE: 07/31/2005
RESPS:9,000 HOURS:4,500 COSTS(000):$0
Application for amendment to license for export or import of
classified or unclassified defense articles and related
technical data
FORMS: DSP-119
OMB NO: 1405-0093 EXPIRATION DATE: 07/31/2005
RESPS:5,000 HOURS:10,000 COSTS(000):$0
Request for approval of manufacturing license agreements,
technical assistance agreements and other agreements
FORMS: NONE
OMB NO: 1405-0095 EXPIRATION DATE: 07/31/2004
RESPS:10,000 HOURS:1,666 COSTS(000):$0
Shrimp Exporter's/Importer's Declaration
FORMS: DS-2031
OMB NO: 1405-0096 EXPIRATION DATE: 05/31/2004
RESPS:18,500 HOURS:18,500 COSTS(000):$0
Nonimmigrant Fiance(e) Visa Application
FORMS: DS-156K
OMB NO: 1405-0098 EXPIRATION DATE: 06/30/2003
RESPS:90,000 HOURS:45,000 COSTS(000):$0
Supplemental Registration for the Diversity Immigrant Visa
Program
FORMS: DSP-122
OMB NO: 1405-0100 EXPIRATION DATE: 06/30/2003
RESPS:20,000 HOURS:10,000 COSTS(000):$0
Application for A, G, or NATO Visa
FORMS: DS-1648
OMB NO: 1405-0101 EXPIRATION DATE: 05/31/2004
RESPS:17,000 HOURS:34,000 COSTS(000):$0
Nonimmigrant Treaty Trader/Investor Application
FORMS: DS-156E
OMB NO: 1405-0102 EXPIRATION DATE: 12/31/2004
RESPS:80,000 HOURS:40,000 COSTS(000):$0
Refugee BiographicDData
FORMS: NONE
OMB NO: 1405-0104 EXPIRATION DATE: 02/28/2005
RESPS:13,200 HOURS:3,072 COSTS(000):$0
Request for Customs Clearance of Merchandise
FORMS: DS-1504
OMB NO: 1405-0105 EXPIRATION DATE: 04/30/2005
RESPS:12,500 HOURS:6,250 COSTS(000):$0
United States Department of State Driver License and Tax
Exemption Card Application
FORMS: DS-1972
OMB NO: 1405-0111 EXPIRATION DATE: 07/31/2005
RESPS:5,000 HOURS:100,000 COSTS(000):$1,500
"Maintenance of records by registrants" Section 122.5 of the
International Traffic in Arms Regulations (ITAR)
FORMS: NONE
OMB NO: 1405-0113 EXPIRATION DATE: 01/31/2004
RESPS:700,000 HOURS:1,400,000 COSTS(000):$70,000
Medical Examination of Applicants for United States Visas
FORMS: DS-2053 DS-3024 DS-3025 DS-3026
OMB NO: 1405-0114 EXPIRATION DATE: 09/30/2005
RESPS:862 HOURS:1,724 COSTS(000):$0
Fulbright Teacher and Administrator Exchange Program Application
OMB#1405-0114 U.S. Department of State, Bureau of Education and
Cultural Affairs
FORMS: 4500 4501 4502 4503 4504 4505 4506
OMB NO: 1405-0115 EXPIRATION DATE: 03/31/2005
RESPS:800 HOURS:16,000 COSTS(000):$418
Proposal Submission Instructions
FORMS: DS-2011 DS-2012 DS-2013 DS-2014 DS-2015 DS-2016 DS-2017 DS-2018
OMB NO: 1405-0118 EXPIRATION DATE: 02/28/2005
RESPS:3,877 HOURS:1,938 COSTS(000):$0
Evaluation of DOS-sponsored Educational and Cultural Exchange
Programs (formerly, USIA-sponsored Educational and Cultural
Exchange Activities; USIA Program Participant Survey
FORMS: NONE
OMB NO: 1405-0119 EXPIRATION DATE: 02/28/2005
RESPS:300,000 HOURS:225,000 COSTS(000):$5,625
Certificate of Eligibility for Exchange Visitor (J-1) Status
FORMS: DS-2019
OMB NO: 1405-0120 EXPIRATION DATE: 09/30/2005
RESPS:3,150 HOURS:2,200 COSTS(000):$119,850
Exchange Visitor Program
FORMS: 3036 3037
OMB NO: 1405-0124 EXPIRATION DATE: 08/31/2003
RESPS:20,200 HOURS:12,400 COSTS(000):$0
Irish Peace Process Cultural and Training Program (IPPCTP)
Employer Information Collection
FORMS: NONE
OMB NO: 1405-0126 EXPIRATION DATE: 10/31/2003
RESPS:350,000 HOURS:175,000 COSTS(000):$0
Choice of Address and Agent for US Department of State Immigrant
Visa Applicants
FORMS: NONE
OMB NO: 1405-0128 EXPIRATION DATE: 06/30/2003
RESPS:100,000 HOURS:100,000 COSTS(000):$0
Nonimmigrant V Visa Application
FORMS: DS-3052
OMB NO: 1405-0129 EXPIRATION DATE: 03/31/2005
RESPS:1,300,000 HOURS:108,300 COSTS(000):$0
Statement of Consent: Issuance of a passport to a minor under
the age of 14
FORMS: DS-3053
OMB NO: 1405-0131 EXPIRATION DATE: 05/31/2005
RESPS:12,000 HOURS:3,000 COSTS(000):$0
Medical Clearance Update
FORMS: DS-3057
OMB NO: 1405-0132 EXPIRATION DATE: 11/30/2004
RESPS:81,500 HOURS:20,375 COSTS(000):$0
Birth Affidavit
FORMS: DS-10
OMB NO: 1405-0133 EXPIRATION DATE: 11/30/2004
RESPS:106,800 HOURS:26,700 COSTS(000):$0
Affidavit regarding change of name
FORMS: DS-60
OMB NO: 1405-0134 EXPIRATION DATE: 07/31/2005
RESPS:960,000 HOURS:9,600,000 COSTS(000):$0
Supplemental Nonimmigrant Visa Application
FORMS: DS-157
OMB NO: 1405-0135 EXPIRATION DATE: 03/31/2005
RESPS:10,000 HOURS:20,000 COSTS(000):$1,360
J-1 Visa Waiver Review Application
FORMS: DS-3035
OMB NO: 1405-0137 EXPIRATION DATE: 04/30/2005
RESPS:1,485 HOURS:743 COSTS(000):$0
Evaluation of DOS-Sponsored Citizen Exchange Programs
FORMS: NONE
OMB NO: 1405-0138 EXPIRATION DATE: 04/30/2005
RESPS:2,386 HOURS:1,193 COSTS(000):$0
Evaluation of DOS-Sponsored Academic Exchange Programs
FORMS: NONE
OMB NO: 1405-0139 EXPIRATION DATE: 05/31/2005
RESPS:25,000 HOURS:12,500 COSTS(000):$0
U.S. Department of State, Application for Employment, DS-1950
FORMS: DS-1950
OMB NO: 1405-0141 EXPIRATION DATE: 07/31/2005
RESPS:500 HOURS:1,000 COSTS(000):$0
Reporting on brokering activities
FORMS: NONE
OMB NO: 1405-0142 EXPIRATION DATE: 07/31/2005
RESPS:30 HOURS:60 COSTS(000):$0
Prior approval for brokering activity
FORMS: NONE
OMB NO: 1405-0143 EXPIRATION DATE: 05/31/2005
RESPS:250 HOURS:3,750 COSTS(000):$0
Thomas R. Pickering Foreign Affairs Fellowship Program
FORMS: DS-3091
OMB NO: 1405-0144 EXPIRATION DATE: 04/30/2003
RESPS:2,500,000 HOURS:2,500,000 COSTS(000):$0
Contact Information and Work History For Nonimmigrant Visa
Applicant
FORMS: DS-158
OMB NO: 1405-0145 EXPIRATION DATE: 09/30/2005
RESPS:200 HOURS:100 COSTS(000):$54
Training Registration Form (For Non-US Government Persons)
FORMS: 3083
OMB NO: 1405-0146 EXPIRATION DATE: 12/31/2005
RESPS:20,000 HOURS:1,667 COSTS(000):$0
Statement of Non-Receipt of a Passport
FORMS: DS-86
OMB NO: 1405-0147 EXPIRATION DATE: 06/30/2003
RESPS:1,666 HOURS:272,100 COSTS(000):$0
22 CFR Part 62
FORMS: NONE
OMB NO: 1405-0148 EXPIRATION DATE: 09/30/2003
RESPS:3,120 HOURS:6,240 COSTS(000):$0
Technical Assistance Agreement (TAA) Cover Letter; Technical
Assistance Agreement
FORMS: DS-4028 DS-4029
OMB NO: 1405-0150 EXPIRATION DATE: 09/30/2003
RESPS:500 HOURS:83 COSTS(000):$0
Emergency Loan Application and Evacuation Documentation
FORMS: DS-3072
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
70 27,565,272 29,420,432 $1,482,890
AGENCY TOTALS:
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
70 27,565,272 29,420,432 $1,482,890
Department of Transportation
Department of Transportation
OMB NO: 2100-0019 EXPIRATION DATE: 06/30/2005
RESPS:3,448 HOURS:316,226 COSTS(000):$0
American with Disabilities; Information Collection Requirements
for Final Rule on Over-the-Road Buses
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
1 3,448 316,226 $0
Office of the Secretary
OMB NO: 2105-0009 EXPIRATION DATE: 02/28/2006
RESPS:1 HOURS:25 COSTS(000):$0
Advisory Committee Candidate Biographical Information Request
FORMS: F1120.1
OMB NO: 2105-0508 EXPIRATION DATE: 09/30/2004
RESPS:1,460 HOURS:29,043 COSTS(000):$0
Uniform Relocation Assistance and Real Property Acquisition
Regulations for Federal and Federally Assisted Programs
FORMS: NONE
OMB NO: 2105-0510 EXPIRATION DATE: 04/30/2003
RESPS:1,798 HOURS:1,456,683 COSTS(000):$0
Report of DBE Awards and Commitments
FORMS: DOT-F4630
OMB NO: 2105-0517 EXPIRATION DATE: 11/30/2003
RESPS:25,094 HOURS:33,115 COSTS(000):$0
Transportation Acquisition Regulation (TAR)
FORMS: DOT-F-4220.4 4220.7 4220.43 4220.45 4220.46 FORM-DD882
OMB NO: 2105-0520 EXPIRATION DATE: 10/31/2004
RESPS:7,180 HOURS:125,650 COSTS(000):$0
Uniform Administrative Requirements for Grants and Cooperative
Agreements to State and Local Governments
FORMS: 269 270 271 272 424
OMB NO: 2105-0529 EXPIRATION DATE: 01/31/2004
RESPS:8,475,340 HOURS:842,478 COSTS(000):$0
Procedures for Transportation Drug and Alcohol Testing Program
FORMS: NONE
OMB NO: 2105-0531 EXPIRATION DATE: 08/31/2004
RESPS:600 HOURS:10,500 COSTS(000):$0
Uniform Administrative Requirements for Grants and Agreements
with Institutions of Higher Education, Hospitals and Other Non-
Profit Organizations
FORMS: NONE
OMB NO: 2105-0534 EXPIRATION DATE: 03/31/2004
RESPS:55,800,000 HOURS:1,050,000 COSTS(000):$0
Passenger Manifest Information
FORMS: NONE
OMB NO: 2105-0537 EXPIRATION DATE: 09/30/2005
RESPS:102 HOURS:849,988 COSTS(000):$0
Disclosure of Code-Sharing Arrangements and Long-Term Wet Leases
FORMS: NONE
OMB NO: 2105-0538 EXPIRATION DATE: 09/30/2005
RESPS:740,000,000 HOURS:308,861 COSTS(000):$0
Disclosure of Change-of-gauge Services
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
10 804,311,575 4,706,343 $0
Office of the Secretary - Aviation
OMB NO: 2106-0005 EXPIRATION DATE: 01/31/2006
RESPS:1,738 HOURS:1,343 COSTS(000):$0
Public Charter-14 CFR Part 380
FORMS: 4532 4533 4534 4535
OMB NO: 2106-0009 EXPIRATION DATE: 09/30/2005
RESPS:3,068,200 HOURS:650,000 COSTS(000):$0
14 CFR Part 221 - Construction, Publication, Filing and Posting
of Tariffs of Air Carriers and Foreign Air Carriers
FORMS: NONE
OMB NO: 2106-0023 EXPIRATION DATE: 11/30/2003
RESPS:127 HOURS:4,604 COSTS(000):$0
Procedures & Evidence rules for Air Carrier Authority
Applications
FORMS: NONE
OMB NO: 2106-0030 EXPIRATION DATE: 02/29/2004
RESPS:5,525 HOURS:2,763 COSTS(000):$0
Aircraft Accident Liability Insurance
FORMS: OST-FORM-6410 OST-FORM-6411
OMB NO: 2106-0043 EXPIRATION DATE: 09/30/2003
RESPS:15 HOURS:69 COSTS(000):$0
Use and Change of Names of Air Carriers, Foreign Air Carriers,
and Commuter Air Carriers
FORMS: NONE
OMB NO: 2106-0044 EXPIRATION DATE: 09/30/2003
RESPS:816 HOURS:4,176 COSTS(000):$0
Supporting Statements--Air Carriers' claims for subsidy payments
FORMS: OST-FORM-397 OST-FORM-398
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
6 3,076,421 662,955 $0
Federal Aviation Administration
OMB NO: 2120-0001 EXPIRATION DATE: 05/31/2004
RESPS:53,000 HOURS:15,500 COSTS(000):$0
Notice of Proposed Construction or Alteration, Notice of Actual
Construction or Alteration, & Project Status Report
FORMS: FORM-7460-1 FORM-7460-2
OMB NO: 2120-0003 EXPIRATION DATE: 07/31/2005
RESPS:56,045 HOURS:8,407 COSTS(000):$0
Malfunction or Defect Report
FORMS: 8010-4
OMB NO: 2120-0005 EXPIRATION DATE: 02/28/2005
RESPS:21,197 HOURS:231,064 COSTS(000):$0
General Operating and Flight Rules - 14 CFR Part 91
FORMS: NONE
OMB NO: 2120-0007 EXPIRATION DATE: 12/31/2005
RESPS:4,891 HOURS:1,416 COSTS(000):$0
Flight Engineers and Flight Navigators-FAR Part 63
FORMS: 8400-3
OMB NO: 2120-0008 EXPIRATION DATE: 12/31/2005
RESPS:61,844 HOURS:1,273,247 COSTS(000):$0
Part 121-Operating Requirements: Domestic, Flag, and
Supplemental Operations
FORMS: 8070-1
OMB NO: 2120-0009 EXPIRATION DATE: 09/30/2005
RESPS:524 HOURS:28,878 COSTS(000):$0
Pilot Schools-FAR 141
FORMS: 8420-8
OMB NO: 2120-0010 EXPIRATION DATE: 04/30/2003
RESPS:1,100 HOURS:304,647 COSTS(000):$0
Repair Station Certification
FORMS: 8310-3
OMB NO: 2120-0014 EXPIRATION DATE: 12/31/2005
RESPS:2,413 HOURS:33,116 COSTS(000):$0
Procedures for non-Federal Navigational Facilities, FAR Part 171
FORMS: 6030-1 6030-17 6790-4 6790-5
OMB NO: 2120-0015 EXPIRATION DATE: 10/31/2005
RESPS:19,345 HOURS:8,770 COSTS(000):$0
Airport Master Record
FORMS: 5010-1 5010-2 5010-3 5010-5
OMB NO: 2120-0018 EXPIRATION DATE: 07/31/2004
RESPS:52,020 HOURS:44,101 COSTS(000):$0
Certification Procedures for Products and Parts FAR 21
FORMS: 8110-12 8130-1 8130-6 8130-9 8130-12
OMB NO: 2120-0020 EXPIRATION DATE: 08/31/2004
RESPS:184,006 HOURS:1,432,784 COSTS(000):$0
Maintenance, Preventive Maintenance, Rebuilding and Alteration
FAR Part 43
FORMS: FAA-337
OMB NO: 2120-0021 EXPIRATION DATE: 04/30/2004
RESPS:125,500 HOURS:252,100 COSTS(000):$0
Certification: Pilots and Flight Instructors
FORMS: FAA8710-1
OMB NO: 2120-0022 EXPIRATION DATE: 06/30/2004
RESPS:34,970 HOURS:34,432 COSTS(000):$0
Certificate: Mechanics, Repairmen, Parachute Riggers, and
Inspection Authorizations-FAR Part 65
FORMS: FAA-FORM-8610-1 FAA-FORM-8610-2
OMB NO: 2120-0024 EXPIRATION DATE: 05/31/2005
RESPS:2,077 HOURS:1,557 COSTS(000):$0
Dealer's Aircraft Registration Application
FORMS: 8050-5
OMB NO: 2120-0026 EXPIRATION DATE: 04/30/2003
RESPS:17,584,302 HOURS:293,072 COSTS(000):$0
Domestic and International Flight Plan Forms
FORMS: 7233-1 7233-4
OMB NO: 2120-0027 EXPIRATION DATE: 06/30/2005
RESPS:25,231 HOURS:12,202 COSTS(000):$0
Application for Certificate of Waiver or Authorization
FORMS: 7711-2
OMB NO: 2120-0033 EXPIRATION DATE: 12/31/2003
RESPS:4,840 HOURS:3,974 COSTS(000):$0
Representatives of the Administrator, FAR 183
FORMS: FAA-8110-14 FAA-8110-28 FAA-8710-9 FAA-8110-10
OMB NO: 2120-0034 EXPIRATION DATE: 11/30/2004
RESPS:483,554 HOURS:707,253 COSTS(000):$0
Medical Standards and Certification (14 CFR part 67) Duration of
Medical Certificates (14 CFR part 61)
FORMS: 8500-7 8500-8 8500-14 8500-20
OMB NO: 2120-0036 EXPIRATION DATE: 01/31/2004
RESPS:3,868 HOURS:2,901 COSTS(000):$0
Notice of Landing Area Proposal
FORMS: FAA/7480-1
OMB NO: 2120-0039 EXPIRATION DATE: 04/30/2003
RESPS:9,050,493 HOURS:1,128,904 COSTS(000):$0
Operating Requirements: Commuter and On-Demand Operation -- 14
CFR Part 135
FORMS: 8070-1
OMB NO: 2120-0040 EXPIRATION DATE: 11/30/2004
RESPS:174 HOURS:66,134 COSTS(000):$0
Aviation Maintenance Technician Schools - FAR Part 147
FORMS: 8310-6
OMB NO: 2120-0042 EXPIRATION DATE: 06/30/2005
RESPS:119,592 HOURS:73,572 COSTS(000):$0
Aircraft Registration
FORMS: AC8050-1 AC8050-2 AC8050-4 AC8050-81 AC8050-98 AC8050-117
OMB NO: 2120-0043 EXPIRATION DATE: 04/30/2003
RESPS:55,406 HOURS:55,406 COSTS(000):$0
Recording of Aircraft Conveyanes and Security Documents
FORMS: AC8050-41
OMB NO: 2120-0044 EXPIRATION DATE: 09/30/2005
RESPS:1,449 HOURS:3,268 COSTS(000):$0
Rotorcraft External-Load Certificate Application
FORMS: 8710-4
OMB NO: 2120-0045 EXPIRATION DATE: 08/31/2003
RESPS:5,000 HOURS:400 COSTS(000):$0
Bird/Other Wildlife Strike
FORMS: FAA-FORM-5200-7
OMB NO: 2120-0049 EXPIRATION DATE: 04/30/2003
RESPS:1,075 HOURS:14,037 COSTS(000):$0
Agricultural Aircraft Operator Certificate Application
FORMS: FAA-FORM-8710-3
OMB NO: 2120-0056 EXPIRATION DATE: 07/31/2004
RESPS:25,725 HOURS:2,144 COSTS(000):$0
Report of Inspections Required by Airworthiness Directives, 14
CFR Part 39
FORMS: NONE
OMB NO: 2120-0057 EXPIRATION DATE: 01/31/2005
RESPS:17,392 HOURS:1,769 COSTS(000):$0
Safety Improvement Report, Accident Prevention Counselor
Activity Reports
FORMS: 8740-5 8740-6
OMB NO: 2120-0060 EXPIRATION DATE: 10/31/2005
RESPS:16,500 HOURS:5,500 COSTS(000):$0
General Aviation/Air Taxi activity and Avionics Survey
FORMS: 1800-54
OMB NO: 2120-0063 EXPIRATION DATE: 05/31/2005
RESPS:274,885 HOURS:173,869 COSTS(000):$0
Certificationof Airports
FORMS: 5280-1
OMB NO: 2120-0067 EXPIRATION DATE: 07/31/2004
RESPS:500 HOURS:750 COSTS(000):$0
Air Taxi and Commercial Operator Activity Survey
FORMS: 1800-31
OMB NO: 2120-0085 EXPIRATION DATE: 04/30/2004
RESPS:45,999 HOURS:29,445 COSTS(000):$0
Certification and Operations: Federal Aviation Regulations Part
125
FORMS: NONE
OMB NO: 2120-0101 EXPIRATION DATE: 07/31/2004
RESPS:5,500 HOURS:733 COSTS(000):$0
Physiological Training
FORMS: FORM-3150-7
OMB NO: 2120-0507 EXPIRATION DATE: 06/30/2005
RESPS:39 HOURS:326 COSTS(000):$0
Special Federal Aviation Regulation (SFAR) 36, development of
Major Repair Data
FORMS: 8100-8
OMB NO: 2120-0508 EXPIRATION DATE: 07/31/2004
RESPS:1,200 HOURS:100 COSTS(000):$0
Fuel Venting and Exhaust Emission Requirements for Turbine
Engine Powered Airplanes
FORMS: NONE
OMB NO: 2120-0514 EXPIRATION DATE: 07/31/2005
RESPS:530 HOURS:1,668 COSTS(000):$0
War Risk Insurance (Formerly Aviation Insurance)
FORMS: NONE
OMB NO: 2120-0517 EXPIRATION DATE: 02/28/2005
RESPS:28 HOURS:50,400 COSTS(000):$0
14 CFR Part 150-Airport Noise Compatibility Planning
FORMS: NONE
OMB NO: 2120-0524 EXPIRATION DATE: 09/30/2004
RESPS:2,742 HOURS:3,064 COSTS(000):$0
High Density Traffic Airports; Slot Allocation and Transfer
Methods
FORMS: NONE
OMB NO: 2120-0535 EXPIRATION DATE: 12/31/2005
RESPS:251,729 HOURS:26,373 COSTS(000):$0
Antidrug and Alcohol Misuse Prevention Programs for Personnel
Engaged in Specified Aviation Activities
FORMS: 9000-2 9000-3
OMB NO: 2120-0539 EXPIRATION DATE: 01/31/2005
RESPS:15 HOURS:600 COSTS(000):$0
Implementation of the Equal Access to Justice Act
FORMS: NONE
OMB NO: 2120-0543 EXPIRATION DATE: 01/31/2006
RESPS:2,184 HOURS:364 COSTS(000):$0
Pilots Convicted of Alcohol or Drug-Related Motor Vehicle
Offenses or Subject to State Motor Vehicle Administrative
Procedures.
FORMS: 8500-8
OMB NO: 2120-0552 EXPIRATION DATE: 04/30/2003
RESPS:400 HOURS:60 COSTS(000):$0
Suspected Unapproved Parts Notification
FORMS: FORM-8120-11
OMB NO: 2120-0557 EXPIRATION DATE: 08/31/2003
RESPS:1,655 HOURS:26,592 COSTS(000):$0
Passenger Facility Charge (PFC) Application
FORMS: FAA-FORM-5500-1
OMB NO: 2120-0559 EXPIRATION DATE: 09/30/2003
RESPS:100 HOURS:1,400 COSTS(000):$0
Aviation Research Grants Program
FORMS: FAA-9550-1 FAA-9550-2 FAA-9550-3 FAA-9550-5 SF-269 SF-270 SF-272
SF-3881 SF-LLL
OMB NO: 2120-0563 EXPIRATION DATE: 11/30/2003
RESPS:8 HOURS:30,000 COSTS(000):$0
Notice and Approval of Airport Noise and Access Restrictions
FORMS: NONE
OMB NO: 2120-0568 EXPIRATION DATE: 05/31/2004
RESPS:33,333 HOURS:6,667 COSTS(000):$0
FAA Flight Standards Customer Satisfaction Survey
FORMS: NONE
OMB NO: 2120-0569 EXPIRATION DATE: 07/31/2004
RESPS:10,176 HOURS:67,714 COSTS(000):$0
Airports Grants Program
FORMS: 5100-100 5100-108 5100-125 5100-126 5370-1
OMB NO: 2120-0570 EXPIRATION DATE: 04/30/2005
RESPS:75 HOURS:6,822 COSTS(000):$0
Part 142-Certificated Training Centers, Simulator Rule
FORMS: 8400-8
OMB NO: 2120-0574 EXPIRATION DATE: 06/30/2005
RESPS:180 HOURS:180 COSTS(000):$0
Aviation Safety Counselor of the Year Award
FORMS: 8740-14
OMB NO: 2120-0587 EXPIRATION DATE: 10/31/2005
RESPS:3,333 HOURS:3,333 COSTS(000):$0
Aviator Safety Studies
FORMS: NONE
OMB NO: 2120-0593 EXPIRATION DATE: 12/31/2004
RESPS:1,702 HOURS:8,855 COSTS(000):$0
Part 119-Certification: Air Carrier and Commercial Operators
FORMS: FORM-8400-6
OMB NO: 2120-0595 EXPIRATION DATE: 05/31/2005
RESPS:264,718 HOURS:1,701,099 COSTS(000):$0
Federal Aviation Administration Acquisition Management System
(FAAAMS)
FORMS: NONE
OMB NO: 2120-0597 EXPIRATION DATE: 04/30/2003
RESPS:50,000 HOURS:75,000 COSTS(000):$0
Application for Employment with the Federal Aviation
Administration
FORMS: 3330.76
OMB NO: 2120-0600 EXPIRATION DATE: 12/31/2005
RESPS:3,000 HOURS:13 COSTS(000):$0
Training and Qualification Requirements for Check Airmen and
Flight Instructors
FORMS: NONE
OMB NO: 2120-0601 EXPIRATION DATE: 08/31/2005
RESPS:5 HOURS:1,305 COSTS(000):$0
Commercial Space Transportation Financial Responsibility for
Licensed Launch Activities
FORMS: NONE
OMB NO: 2120-0604 EXPIRATION DATE: 12/31/2005
RESPS:450 HOURS:225 COSTS(000):$0
Aviation Medical Examiner Program
FORMS: 8520-2
OMB NO: 2120-0605 EXPIRATION DATE: 01/31/2006
RESPS:200 HOURS:100 COSTS(000):$0
ACSEP Evaluation Customer Feedback Report
FORMS: 8100.7
OMB NO: 2120-0607 EXPIRATION DATE: 02/29/2004
RESPS:232,488 HOURS:101,708 COSTS(000):$0
Pilot Records Improvement Act of 1996
FORMS: 8060-10 8060-11
OMB NO: 2120-0608 EXPIRATION DATE: 04/30/2003
RESPS:8 HOURS:3,236 COSTS(000):$0
Commercial Space Transportation Licensing Regulations
FORMS: NONE
OMB NO: 2120-0611 EXPIRATION DATE: 11/30/2003
RESPS:300 HOURS:300 COSTS(000):$0
Associate Administrator for Commercial Space Transportation
(AST) Customer Service Survey
FORMS: NONE
OMB NO: 2120-0614 EXPIRATION DATE: 08/31/2003
RESPS:360 HOURS:720 COSTS(000):$0
Revised Standards for Cargo or Baggage Compartments in Transport
Category Airplanes
FORMS: NONE
OMB NO: 2120-0616 EXPIRATION DATE: 08/31/2003
RESPS:2,960 HOURS:1 COSTS(000):$54,600
Revisions to Digital Flight Data Recorders
FORMS: NONE
OMB NO: 2120-0618 EXPIRATION DATE: 12/31/2003
RESPS:600 HOURS:50 COSTS(000):$0
Overflight Billing and Collection Customer Information Form
FORMS: NONE
OMB NO: 2120-0620 EXPIRATION DATE: 01/31/2004
RESPS:100,000 HOURS:6,667 COSTS(000):$0
Special Federal Aviation Regulation No. 71
FORMS: NONE
OMB NO: 2120-0631 EXPIRATION DATE: 07/31/2004
RESPS:1 HOURS:1 COSTS(000):$140,000
Terrain Awareness and Warning System (TAWS)
FORMS: NONE
OMB NO: 2120-0632 EXPIRATION DATE: 01/31/2005
RESPS:40 HOURS:820 COSTS(000):$0
Office of Dispute Resolution Procedures for Protests and
Contract Disputes, 14 CFR part 17
FORMS: NONE
OMB NO: 2120-0633 EXPIRATION DATE: 09/30/2005
RESPS:2,059 HOURS:1,026 COSTS(000):$0
Exemptions for Air Taxi and Commuter Air Carrier Operations
FORMS: OST-FORM-4507
OMB NO: 2120-0643 EXPIRATION DATE: 05/31/2005
RESPS:35 HOURS:4,384 COSTS(000):$0
Commerical Space Transportation Reusable Launch Vehicle and
Reentry Licensing Regulations
FORMS: NONE
OMB NO: 2120-0644 EXPIRATION DATE: 07/31/2005
RESPS:2 HOURS:1,592 COSTS(000):$0
Commercial Space Transportation Licensing Requirements for
Operation of a Launch Site
FORMS: NONE
OMB NO: 2120-0646 EXPIRATION DATE: 08/31/2005
RESPS:5 HOURS:5 COSTS(000):$0
Protection of Voluntarily Submitted Information
FORMS: NONE
OMB NO: 2120-0648 EXPIRATION DATE: 11/30/2005
RESPS:82 HOURS:4,679 COSTS(000):$0
Part 65, Certification: Airmen Other Than Flight Crewmembers,
Subpart C, Aircraft Dispatchers and Appendix A, Aircraft
Dispatcher Courses
FORMS: NONE
OMB NO: 2120-0649 EXPIRATION DATE: 11/30/2005
RESPS:5 HOURS:1,305 COSTS(000):$0
Financil Responsibility Requirements for Licensed Reentry
Activities
FORMS: NONE
OMB NO: 2120-0651 EXPIRATION DATE: 01/31/2006
RESPS:1,200 HOURS:1 COSTS(000):$205,000
Additional Flight Data Recorder Requirements for certain Boeing
737 Airplanes
FORMS: NONE
OMB NO: 2120-0652 EXPIRATION DATE: 04/30/2003
RESPS:100 HOURS:25 COSTS(000):$0
Changes in Permissible Stage 2 Airplane Operations
FORMS: NONE
OMB NO: 2120-0653 EXPIRATION DATE: 01/31/2006
RESPS:81 HOURS:86 COSTS(000):$0
Part 93, Subpart U-Special Flight Rules in the Vicinity of Grand
Canyon National Park, AZ (formerly titled Commercial Air Tour
Limitation in the Grand Canyon National Park Special Flight Rules
FORMS: NONE
OMB NO: 2120-0657 EXPIRATION DATE: 09/30/2003
RESPS:2,558 HOURS:18,815 COSTS(000):$0
Type Certification Procedures for Changed Products
FORMS: NONE
OMB NO: 2120-0659 EXPIRATION DATE: 09/30/2003
RESPS:10 HOURS:1,350 COSTS(000):$0
Noise Certification Standards for Subsonic Jet Airplanes and
Subsonic Transport Category Large Airplanes
FORMS: NONE
OMB NO: 2120-0660 EXPIRATION DATE: 09/30/2003
RESPS:360 HOURS:360 COSTS(000):$0
Flight Operational Quality Assurance (FOQA) Program
FORMS: NONE
OMB NO: 2120-0661 EXPIRATION DATE: 09/30/2003
RESPS:82 HOURS:5,945 COSTS(000):$0
Competition Plans, Passenger Facility Charges
FORMS: NONE
OMB NO: 2120-0662 EXPIRATION DATE: 09/30/2003
RESPS:200 HOURS:2,200 COSTS(000):$0
Laser Operations in the Navigable Airspace (Advisory Circular
(AC), Outdoor Laser Operations)
FORMS: NONE
OMB NO: 2120-0663 EXPIRATION DATE: 11/30/2003
RESPS:41,500 HOURS:6,107 COSTS(000):$0
Service Difficulty Report (SDR)
FORMS: FAA-FORM-8070-1
OMB NO: 2120-0664 EXPIRATION DATE: 11/30/2003
RESPS:100 HOURS:100 COSTS(000):$0
Volcanic Activity User Needs Analysis Questionnaire
FORMS: NONE
OMB NO: 2120-0665 EXPIRATION DATE: 12/31/2003
RESPS:625,000 HOURS:52,000 COSTS(000):$0
Safe Disposition of Life-Limited Aircraft Parts
FORMS: NONE
OMB NO: 2120-0666 EXPIRATION DATE: 04/30/2004
RESPS:50 HOURS:875 COSTS(000):$0
Noise Levels for U.S. Certificated and Foreign Aircraft; Estimat
Estimated Airplan Noise Levels in A-Weighted Decibels
FORMS: NONE
OMB NO: 2120-0668 EXPIRATION DATE: 08/31/2004
RESPS:9 HOURS:27 COSTS(000):$0
FAA Form 1200-5, NAS Data Release Request
FORMS: FORM-1200-5
OMB NO: 2120-0669 EXPIRATION DATE: 12/31/2003
RESPS:50 HOURS:67 COSTS(000):$0
Flight Data Recorder Resolution Requirements
FORMS: NONE
OMB NO: 2120-0672 EXPIRATION DATE: 12/31/2004
RESPS:10 HOURS:5,680 COSTS(000):$0
Criteria for internet communications of aviation weather, notam
and aeronautical data
FORMS: NONE
OMB NO: 2120-0674 EXPIRATION DATE: 05/31/2005
RESPS:49 HOURS:2,352 COSTS(000):$0
Special Federal Aviation Regulation (SFAR) 92, Flightcrew
Compartment Access and Door Designs
FORMS: NONE
OMB NO: 2120-0675 EXPIRATION DATE: 02/28/2005
RESPS:2,269 HOURS:52,993 COSTS(000):$0
Certification of Airports, 14 CFR Part 139 (Final Rule)
FORMS: 5281-1
OMB NO: 2120-0677 EXPIRATION DATE: 09/30/2005
RESPS:89,450 HOURS:8,269 COSTS(000):$0
Enhanced Security Procedures at Certain Airports, Washington DC
Area
FORMS: NONE
OMB NO: 2120-0679 EXPIRATION DATE: 06/30/2005
RESPS:2,275 HOURS:68,250 COSTS(000):$334,756
Reduced Vertical Separation Minimum
FORMS: NONE
OMB NO: 2120-0680 EXPIRATION DATE: 09/30/2005
RESPS:450 HOURS:201,653 COSTS(000):$0
Part 60-Flight Simulation Device Initial and Continuing
Qualification and Use (NPRM)
FORMS: NONE
OMB NO: 2120-0682 EXPIRATION DATE: 12/31/2005
RESPS:19,497 HOURS:270,239 COSTS(000):$0
New Final Rule Certification of Repair Stations, Part 145 of
Title 14, CFR
FORMS: 8310-3
OMB NO: 2120-0683 EXPIRATION DATE: 01/31/2006
RESPS:174 HOURS:1,218 COSTS(000):$0
National Parks Air Tour Management, 14 CFR Part 136
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
94 30,092,638 9,082,718 $734,356
Federal Highway Administration
OMB NO: 2125-0010 EXPIRATION DATE: 03/31/2004
RESPS:1,300 HOURS:975 COSTS(000):$0
Bid Price Data
FORMS: FHWA-45
OMB NO: 2125-0019 EXPIRATION DATE: 01/31/2004
RESPS:4,552 HOURS:3,916 COSTS(000):$0
Federal-Aid Highway Construction Equal Employment Opportunity
FORMS: PR-1391 PR-1392
OMB NO: 2125-0025 EXPIRATION DATE: 05/31/2004
RESPS:52 HOURS:10,400 COSTS(000):$0
Highway Safety Improvement Programs
FORMS: NONE
OMB NO: 2125-0028 EXPIRATION DATE: 04/30/2003
RESPS:56 HOURS:74,960 COSTS(000):$0
Highway Performance Monitoring System (HPMS) Field Manual
FORMS: NONE
OMB NO: 2125-0032 EXPIRATION DATE: 03/31/2006
RESPS:1,826 HOURS:42,206 COSTS(000):$0
A Guide to Reporting Highway Statistics
FORMS: FHWA-531 532 534 536 539 541 542 543 551M 556
OMB NO: 2125-0033 EXPIRATION DATE: 12/31/2003
RESPS:1,300 HOURS:8,450 COSTS(000):$0
Statement of Materials and Labor used by Contractors on Highway
Construction involving Federal Funds
FORMS: FHWA-47
OMB NO: 2125-0034 EXPIRATION DATE: 05/31/2003
RESPS:104 HOURS:4,160 COSTS(000):$0
Certification of Enforcement of Vehicle Size and Weight Laws
FORMS: NONE
OMB NO: 2125-0039 EXPIRATION DATE: 04/30/2004
RESPS:52 HOURS:29,120 COSTS(000):$0
Planning and Research Program Administration
FORMS: NONE
OMB NO: 2125-0501 EXPIRATION DATE: 04/30/2004
RESPS:270,000 HOURS:540,000 COSTS(000):$0
Structure Inventory and Appraisal Sheet
FORMS: NONE
OMB NO: 2125-0507 EXPIRATION DATE: 08/31/2004
RESPS:12,300 HOURS:6,150 COSTS(000):$0
Voucher for Federal-aid Reimbursements
FORMS: PR-20
OMB NO: 2125-0514 EXPIRATION DATE: 08/31/2004
RESPS:5 HOURS:1,400 COSTS(000):$3
Develop and Submit Utility Accommodation Policies
FORMS: NONE
OMB NO: 2125-0515 EXPIRATION DATE: 08/31/2004
RESPS:5 HOURS:90 COSTS(000):$1
Eligibility Statement for Utility Adjustment
FORMS: NONE
OMB NO: 2125-0519 EXPIRATION DATE: 10/31/2003
RESPS:9,000 HOURS:72,000 COSTS(000):$180
Developing and Recording Costs for Utility Adjustments
FORMS: NONE
OMB NO: 2125-0521 EXPIRATION DATE: 10/31/2003
RESPS:1,200 HOURS:9,600 COSTS(000):$24
Developing and Recording Costs for Railroad Adjustments
FORMS: NONE
OMB NO: 2125-0522 EXPIRATION DATE: 10/31/2003
RESPS:69,000 HOURS:414,000 COSTS(000):$690
Utility Use and Occupancy Agreements
FORMS: NONE
OMB NO: 2125-0525 EXPIRATION DATE: 05/31/2004
RESPS:30 HOURS:6,000 COSTS(000):$1
Emergency Relief Funding Applications
FORMS: NONE
OMB NO: 2125-0529 EXPIRATION DATE: 06/30/2004
RESPS:12,040 HOURS:12,040 COSTS(000):$0
Preparation and Execution of the Project Agreement and
Modifications
FORMS: NONE
OMB NO: 2125-0541 EXPIRATION DATE: 08/31/2004
RESPS:51 HOURS:612 COSTS(000):$0
Certification of Enforcement of Heavy Vehicle Use Tax
FORMS: NONE
OMB NO: 2125-0545 EXPIRATION DATE: 02/29/2004
RESPS:25,000 HOURS:20,833 COSTS(000):$0
Nationwide Personal Transportation Survey (NPTS)
FORMS: NONE
OMB NO: 2125-0579 EXPIRATION DATE: 06/30/2004
RESPS:52 HOURS:260 COSTS(000):$0
Drug Offenders' Drivers' License Suspension Certification
FORMS: NONE
OMB NO: 2125-0586 EXPIRATION DATE: 08/31/2003
RESPS:52 HOURS:4,000 COSTS(000):$0
State Right-of-Way Operations Manuals
FORMS: NONE
OMB NO: 2125-0587 EXPIRATION DATE: 04/30/2004
RESPS:51 HOURS:2,550 COSTS(000):$0
Heavy Vehicle Travel Information System (HVTIS)
FORMS: NONE
OMB NO: 2125-0589 EXPIRATION DATE: 01/31/2005
RESPS:500 HOURS:84 COSTS(000):$0
FHWA Highway Design Handbook for Older Drivers and Pedestrians
Workshop Participants' Feedback Survey
FORMS: NONE
OMB NO: 2125-0590 EXPIRATION DATE: 02/28/2005
RESPS:65,662 HOURS:1,755 COSTS(000):$0
Customer Satisfaction Surveys
FORMS: 2125-0590R
OMB NO: 2125-0591 EXPIRATION DATE: 08/31/2003
RESPS:675 HOURS:338 COSTS(000):$0
Environmental Streamlining Measuring the Performance of
Stakeholders in the Transportation Project Development Process
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
25 474,865 1,265,899 $899
Federal Motor Carrier Safety Administration
OMB NO: 2126-0001 EXPIRATION DATE: 12/31/2005
RESPS:1,550,023,200 HOURS:162,200,492 COSTS(000):$64,026
Driver's Record of Duty Status
FORMS: NONE
OMB NO: 2126-0003 EXPIRATION DATE: 12/31/2005
RESPS:4,888,430 HOURS:35,408,332 COSTS(000):$226
Inspection, Repair, and Maintenance
FORMS: NONE
OMB NO: 2126-0004 EXPIRATION DATE: 12/31/2005
RESPS:6,458,430 HOURS:951,023 COSTS(000):$28,094
Driver Qualification Files
FORMS: NONE
OMB NO: 2126-0006 EXPIRATION DATE: 12/31/2005
RESPS:3,229,215 HOURS:1,184,826 COSTS(000):$0
Medical Qualification Requirements
FORMS: NONE
OMB NO: 2126-0008 EXPIRATION DATE: 06/30/2003
RESPS:118,590 HOURS:5,285 COSTS(000):$0
Financial Responsibility for Motor Carriers of Passengers and
Motor Carriers of Property
FORMS: MCS-90 MCS-90B MCS-82 MCS-82B
OMB NO: 2126-0009 EXPIRATION DATE: 09/30/2005
RESPS:125,150 HOURS:37,800 COSTS(000):$0
Accident Recordkeeping Requirements
FORMS: NONE
OMB NO: 2126-0010 EXPIRATION DATE: 06/30/2004
RESPS:2,200,265 HOURS:8,520 COSTS(000):$250
Motor Carrier Safety Assistance Program (MCSAP)
FORMS: MCSAP-1 MCSAP-2 MCSAP-2A
OMB NO: 2126-0011 EXPIRATION DATE: 10/31/2005
RESPS:10,241,818 HOURS:819,982 COSTS(000):$11,400
Commercial Driver Licensing and Testing Standards
FORMS: NONE
OMB NO: 2126-0012 EXPIRATION DATE: 08/31/2004
RESPS:5,969,686 HOURS:573,490 COSTS(000):$0
Controlled Substances and Alcohol Use and Testing
FORMS: MCS-154 NCS-155
OMB NO: 2126-0013 EXPIRATION DATE: 07/31/2005
RESPS:274,500 HOURS:74,250 COSTS(000):$0
Motor Carrier Identification Report
FORMS: MCS-150 MCS-150A
OMB NO: 2126-0014 EXPIRATION DATE: 08/31/2004
RESPS:53 HOURS:13 COSTS(000):$0
Transportation of Hazardous Materials; Highway Routing
FORMS: NONE
OMB NO: 2126-0015 EXPIRATION DATE: 11/30/2004
RESPS:30,000 HOURS:5,000 COSTS(000):$1
Designation of Agents, Motor Carriers, Brokers and Freight
Forwarders
FORMS: BOC-3
OMB NO: 2126-0016 EXPIRATION DATE: 03/31/2005
RESPS:26,637 HOURS:59,001 COSTS(000):$7,479
Revision of Licensing Application Forms, Application Procedures,
and Corresponding Regulations
FORMS: OP-1(MX) OP-1 OP-1(FF) OP-1(P)
OMB NO: 2126-0017 EXPIRATION DATE: 09/30/2005
RESPS:270,157 HOURS:45,225 COSTS(000):$173
Financial Responsibility, Trucking and Freight Forwarding
FORMS: 91 91X 34 82 83 84 85 90 32 35/36/40
OMB NO: 2126-0018 EXPIRATION DATE: 04/30/2004
RESPS:1,000 HOURS:250 COSTS(000):$0
Request for Revocation of Authority Granted
FORMS: OCE-46
OMB NO: 2126-0019 EXPIRATION DATE: 03/31/2005
RESPS:7,218 HOURS:23,818 COSTS(000):$307
Application for Certificate of Registration for Foreign Motor
Carriers and Foreign Motor Private Carriers
FORMS: OP-2
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
16 1,583,864,349 201,397,307 $111,956
National Highway Traffic Safety Administration
OMB NO: 2127-0001 EXPIRATION DATE: 07/31/2003
RESPS:10,470,555 HOURS:1,852 COSTS(000):$0
National Driver Register (NDR)
FORMS: NONE
OMB NO: 2127-0002 EXPIRATION DATE: 05/31/2003
RESPS:838,000 HOURS:72,500 COSTS(000):$2
Motor Vehicle Importation
FORMS: HS-7 HS-474
OMB NO: 2127-0003 EXPIRATION DATE: 03/31/2005
RESPS:1,140 HOURS:570 COSTS(000):$0
23 CFR Parts Uniform Safety Program Cost Summary Form for
Highway Safety Plan
FORMS: FORM-217
OMB NO: 2127-0004 EXPIRATION DATE: 02/28/2006
RESPS:3,527 HOURS:15,844 COSTS(000):$0
Defect and Noncompliance Notification
FORMS: NONE
OMB NO: 2127-0006 EXPIRATION DATE: 01/31/2005
RESPS:136,500 HOURS:45,045 COSTS(000):$0
Consumer Compliant/Recall Audit Information
FORMS: 350 350C
OMB NO: 2127-0008 EXPIRATION DATE: 02/28/2005
RESPS:136,500 HOURS:45,045 COSTS(000):$0
Consumer Complaint/Recall Audit Information
FORMS: 350 350C
OMB NO: 2127-0019 EXPIRATION DATE: 09/30/2004
RESPS:36 HOURS:3,474 COSTS(000):$721
49 CFR Part 537--Automotive Fuel Economy Reports
FORMS: NONE
OMB NO: 2127-0021 EXPIRATION DATE: 05/31/2003
RESPS:13,500 HOURS:5,807 COSTS(000):$0
National Automotive Sampling System (NASS) Crashworthiness Data
Systems (CDS)
FORMS: HS-433A HS-433B HS-435H HS-435I
OMB NO: 2127-0025 EXPIRATION DATE: 02/28/2005
RESPS:266 HOURS:1,064 COSTS(000):$0
49 CFR Part 512, Confidential Business Information
FORMS: NONE
OMB NO: 2127-0038 EXPIRATION DATE: 11/30/2004
RESPS:23 HOURS:11 COSTS(000):$0
Assigning DOT Code Numbers to Glazing Material Manufacturers
FORMS: NONE
OMB NO: 2127-0039 EXPIRATION DATE: 02/28/2005
RESPS:21 HOURS:21 COSTS(000):$0
49 CFR Part 557, Petitions for Hearings on Notification and
Remedy of Defects.
FORMS: NONE
OMB NO: 2127-0040 EXPIRATION DATE: 05/31/2003
RESPS:70 HOURS:70 COSTS(000):$0
Designation of Agents
FORMS: NONE
OMB NO: 2127-0042 EXPIRATION DATE: 02/28/2005
RESPS:1,000 HOURS:40,000 COSTS(000):$0
49 CFR Part 576 Record Retention
FORMS: NONE
OMB NO: 2127-0043 EXPIRATION DATE: 02/28/2005
RESPS:100 HOURS:25 COSTS(000):$0
49 CFR Part 566 Manufacturers' Identification
FORMS: NONE
OMB NO: 2127-0044 EXPIRATION DATE: 02/28/2005
RESPS:14,250,000 HOURS:950,000 COSTS(000):$467
Names and Addresses of First Purchasers of Motor Vehicles
FORMS: NONE
OMB NO: 2127-0045 EXPIRATION DATE: 02/28/2005
RESPS:15 HOURS:30 COSTS(000):$0
49 CFR 556, Petitions for Inconsequentiality
FORMS: NONE
OMB NO: 2127-0046 EXPIRATION DATE: 02/28/2005
RESPS:20 HOURS:20 COSTS(000):$0
49 CFR Part 552, Petitions for Rulemaking Defect and
Noncompliance Orders
FORMS: NONE
OMB NO: 2127-0047 EXPIRATION DATE: 02/28/2005
RESPS:130,772,582 HOURS:2,432,879 COSTS(000):$0
49 CFR Part 580 Odometer Disclosure Statement
FORMS: NONE
OMB NO: 2127-0049 EXPIRATION DATE: 04/30/2003
RESPS:15 HOURS:300 COSTS(000):$2,362
49 CFR Part 575 Consumer Information Regulations (Section 103
and 105)
FORMS: NONE
OMB NO: 2127-0050 EXPIRATION DATE: 09/30/2003
RESPS:54,000,000 HOURS:245,000 COSTS(000):$5,340
Tire Identification and Recordkeeping
FORMS: NONE
OMB NO: 2127-0052 EXPIRATION DATE: 11/30/2004
RESPS:20 HOURS:30 COSTS(000):$0
Brake Hose Manufacturers Identification
FORMS: NONE
OMB NO: 2127-0501 EXPIRATION DATE: 04/30/2003
RESPS:52 HOURS:2,340 COSTS(000):$0
23 CFR Part 1313 Certification Requirements for State Grants for
Drunk Driving Prevention Programs.
FORMS: HS-217
OMB NO: 2127-0503 EXPIRATION DATE: 12/31/2005
RESPS:190,000,000 HOURS:271,750 COSTS(000):$954
Tire Identification and Recordkeeping
FORMS: NONE
OMB NO: 2127-0506 EXPIRATION DATE: 11/30/2004
RESPS:2,850,000 HOURS:1 COSTS(000):$0
49 CFR Section 571.125, Warning Devices
FORMS: NONE
OMB NO: 2127-0510 EXPIRATION DATE: 01/31/2005
RESPS:22,725,000 HOURS:456,212 COSTS(000):$2
49 CFR Part 541, Consolidated Labeling Requirements for 49 CFR
571.115 Parts 565, 541 and 587
FORMS: NONE
OMB NO: 2127-0511 EXPIRATION DATE: 06/30/2003
RESPS:4,500,000 HOURS:90,000 COSTS(000):$1,229
49 CFR Part 571.213, "Child Restraint Systems"
FORMS: NONE
OMB NO: 2127-0512 EXPIRATION DATE: 11/30/2004
RESPS:83,759,930 HOURS:72,959 COSTS(000):$1,459
Consolidated Labeling Requirements for Motor Vehicles (Except
the V.I.N)
FORMS: NONE
OMB NO: 2127-0518 EXPIRATION DATE: 11/30/2004
RESPS:1,600,000 HOURS:5,333 COSTS(000):$640
49 CFR 571.218, Motorcycle helmets (Labeling)
FORMS: NONE
OMB NO: 2127-0519 EXPIRATION DATE: 11/30/2004
RESPS:131 HOURS:79,650 COSTS(000):$23,000
49 CFR Part 575, 104; Uniform Tire Quality Grading Standard
FORMS: NONE
OMB NO: 2127-0521 EXPIRATION DATE: 07/31/2004
RESPS:70,000,000 HOURS:7,000 COSTS(000):$81
49 CFR Part 571.116 Motor Vehicle Brake Fluids
FORMS: NONE
OMB NO: 2127-0539 EXPIRATION DATE: 11/30/2004
RESPS:40 HOURS:640 COSTS(000):$0
49 CFR Part 542, Procedures for Selecting Lines To Be Covered by
the Theft Prevention Standard
FORMS: NONE
OMB NO: 2127-0541 EXPIRATION DATE: 12/31/2005
RESPS:204 HOURS:1,771 COSTS(000):$3,887
Consolidated Justification of Owner's Manual Requirements for
Vehicle Equipment
FORMS: NONE
OMB NO: 2127-0542 EXPIRATION DATE: 11/30/2004
RESPS:4 HOURS:64 COSTS(000):$0
49 CFR Part 543, Exemption from Vehicle Theft Prevention Standard
FORMS: NONE
OMB NO: 2127-0547 EXPIRATION DATE: 08/31/2003
RESPS:46 HOURS:68,325 COSTS(000):$2,010
Part 544 - Insurer Reporting Requirements -- Motor Vechicle
Theft Law Enforcement Act of 1984
FORMS: NONE
OMB NO: 2127-0563 EXPIRATION DATE: 11/30/2004
RESPS:7 HOURS:28 COSTS(000):$0
Replaceable Light Source Dimensional Information Collection, 49
CFR Part 564
FORMS: NONE
OMB NO: 2127-0569 EXPIRATION DATE: 11/30/2004
RESPS:10,000,000 HOURS:1 COSTS(000):$1
Compliance Labeling of Retroreflective Materials for Heavy
Trailer Conspicuity
FORMS: NONE
OMB NO: 2127-0573 EXPIRATION DATE: 10/31/2004
RESPS:57 HOURS:47,918 COSTS(000):$2,130
49 CFR Part 583--Motor Vehicle Content Labeling
FORMS: NONE
OMB NO: 2127-0576 EXPIRATION DATE: 01/31/2005
RESPS:1,200 HOURS:120 COSTS(000):$0
Voluntary Child Safety Registration Form
FORMS: NONE
OMB NO: 2127-0579 EXPIRATION DATE: 11/30/2004
RESPS:131,334 HOURS:13,468 COSTS(000):$0
Generic Clearance for Customer Surveys
FORMS: 2127-0579L
OMB NO: 2127-0581 EXPIRATION DATE: 11/30/2004
RESPS:35 HOURS:1,260 COSTS(000):$0
Part 589-Upper Interior Component Head Impact Protection
Phase-in Reporting Requirements
FORMS: NONE
OMB NO: 2127-0588 EXPIRATION DATE: 01/31/2004
RESPS:15,000 HOURS:7,500 COSTS(000):$5
Air Bag Deactivation
FORMS: HS-FORM-603 DOT-HS-808-629
OMB NO: 2127-0597 EXPIRATION DATE: 03/31/2005
RESPS:52 HOURS:17,942 COSTS(000):$0
Uniform criteria for State observational surveys of seat belt use
FORMS: NONE
OMB NO: 2127-0599 EXPIRATION DATE: 03/31/2005
RESPS:21 HOURS:1,260 COSTS(000):$0
Part 585 - Advanced Air Bag Phase-In Reporting Requirements
FORMS: NONE
OMB NO: 2127-0600 EXPIRATION DATE: 03/31/2005
RESPS:56 HOURS:1,736 COSTS(000):$0
23 Part 1345 Occupant Protection Incentive Grant Section 405
FORMS: HS-217
OMB NO: 2127-0606 EXPIRATION DATE: 06/30/2003
RESPS:57 HOURS:114 COSTS(000):$0
23 CFR Part 1335-State Highway Safety Data and Traffice Records
Improvements
FORMS: NONE
OMB NO: 2127-0607 EXPIRATION DATE: 10/31/2003
RESPS:12,000 HOURS:3,845 COSTS(000):$0
2000 Motor Vehicle Occupant Safety Survey
FORMS: NONE
OMB NO: 2127-0608 EXPIRATION DATE: 11/30/2003
RESPS:1,520 HOURS:253 COSTS(000):$0
Part Time Seat Belt User Program
FORMS: NONE
OMB NO: 2127-0609 EXPIRATION DATE: 08/31/2004
RESPS:9 HOURS:18 COSTS(000):$0
Criminal Penalty Safe Harbor Provision
FORMS: NONE
OMB NO: 2127-0610 EXPIRATION DATE: 07/31/2004
RESPS:9 HOURS:4 COSTS(000):$0
Reporting of Sale or Lease of Defective or Noncompliant Tires
FORMS: NONE
OMB NO: 2127-0612 EXPIRATION DATE: 10/31/2004
RESPS:5,600 HOURS:1,680 COSTS(000):$0
National Survey of Drinking and Driving Attitudes & Behaviors -
2001
FORMS: NONE
OMB NO: 2127-0613 EXPIRATION DATE: 11/30/2004
RESPS:4,000 HOURS:1,000 COSTS(000):$0
National Survey of Speeding, Driving While Distracted and other
Unsafe Driving Behaviors
FORMS: NONE
OMB NO: 2127-0614 EXPIRATION DATE: 04/30/2005
RESPS:7,500 HOURS:4,373 COSTS(000):$0
Highway Crash Data Collection for Evaluation of Antilock Braking
Systems (ABS) & Rear Impact Guards
FORMS: NONE
OMB NO: 2127-0615 EXPIRATION DATE: 12/31/2004
RESPS:54,800 HOURS:9,133 COSTS(000):$0
Buckle Up America Telephone Surveys 2002-2004
FORMS: NONE
OMB NO: 2127-0616 EXPIRATION DATE: 12/31/2005
RESPS:444 HOURS:240,284 COSTS(000):$70,369
Reporting of Information and Documents about Potential Defects-
Retention of Records 49 CFR Part 579
FORMS: NONE
OMB NO: 2127-0618 EXPIRATION DATE: 12/31/2003
RESPS:12,000 HOURS:4,000 COSTS(000):$0
2002 Motor Vehicle Occupant Safety Survey
FORMS: NONE
OMB NO: 2127-0620 EXPIRATION DATE: 12/31/2005
RESPS:500 HOURS:2,060 COSTS(000):$0
Reporting of Information About Foreign Safety Recalls and
Campaigns Related to Potential Defects
FORMS: NONE
OMB NO: 2127-0621 EXPIRATION DATE: 12/31/2005
RESPS:10 HOURS:144 COSTS(000):$0
FMVSS 571.403 Platform Lift Systems for Motor vehicles. FMVSS
571.404 Platform Lift installation in Motor Vehicles.
FORMS: NONE
OMB NO: 2127-0623 EXPIRATION DATE: 06/30/2003
RESPS:27 HOURS:2,700 COSTS(000):$0
Tire Pressure Reserve and Tire Failure Data Special Order
FORMS: NONE
OMB NO: 2127-0624 EXPIRATION DATE: 10/31/2003
RESPS:840 HOURS:420 COSTS(000):$0
Heavy Vehicle Antilock Braking System and Underride Guard Fleet
Maintenance Study
FORMS: NONE
OMB NO: 2127-0626 EXPIRATION DATE: 09/30/2003
RESPS:12,000 HOURS:3,000 COSTS(000):$0
National Automotive Sampling System Tire Pressure Monitoring
System Study (TPMSS)
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
60 596,318,375 5,279,893 $114,659
Federal Railroad Administration
OMB NO: 2130-0004 EXPIRATION DATE: 09/30/2003
RESPS:5,666,801 HOURS:1,150,330 COSTS(000):$23
Railroad Locomotive Safety Standards and Event Recorders
FORMS: FRA-F-6180.49A
OMB NO: 2130-0005 EXPIRATION DATE: 09/30/2003
RESPS:27,431,566 HOURS:4,067,432 COSTS(000):$1
Hours of Service Regulations
FORMS: FRA-F-6180.3
OMB NO: 2130-0006 EXPIRATION DATE: 07/31/2003
RESPS:1,673,786 HOURS:480,326 COSTS(000):$5
Railroad Signal System Requirements
FORMS: FRA-F-6180.14 FRA-F-6180.47
OMB NO: 2130-0008 EXPIRATION DATE: 12/31/2003
RESPS:12,013,516,275 HOURS:696,174 COSTS(000):$9,438
Inspection Brake System Safety Standards for Freight and Other
FORMS: NONE
OMB NO: 2130-0010 EXPIRATION DATE: 03/31/2004
RESPS:1,635,052 HOURS:1,767,433 COSTS(000):$0
Track Safety Standards (Gage Restraint Measurement Systems
Amendment)
FORMS: NONE
OMB NO: 2130-0017 EXPIRATION DATE: 04/30/2003
RESPS:65,377 HOURS:3,104 COSTS(000):$0
U.S. DOT Crossing Inventory Form
FORMS: FRA-6180.71
OMB NO: 2130-0035 EXPIRATION DATE: 08/31/2003
RESPS:500,343 HOURS:131,192 COSTS(000):$0
Railroad Operating Rules
FORMS: NONE
OMB NO: 2130-0500 EXPIRATION DATE: 11/30/2005
RESPS:81,977 HOURS:47,900 COSTS(000):$176
Accident/Incident Reporting and Recordkeeping
FORMS: 6180.54;55;55A 56;57;78;81;97 98;107
OMB NO: 2130-0502 EXPIRATION DATE: 07/31/2003
RESPS:4 HOURS:4 COSTS(000):$0
Filing of Dedicated Cars
FORMS: NONE
OMB NO: 2130-0504 EXPIRATION DATE: 03/31/2004
RESPS:58 HOURS:7 COSTS(000):$0
Special Notice for Repairs
FORMS: 6180.8 6180.8A
OMB NO: 2130-0505 EXPIRATION DATE: 01/31/2006
RESPS:4,694 HOURS:314 COSTS(000):$1
Inspection and Maintenance Standards For Steam Locomotives
FORMS: FRA-1 FRA-2 FRA-3 FRA-4 FRA-5 FRA-19
OMB NO: 2130-0506 EXPIRATION DATE: 06/30/2003
RESPS:800 HOURS:67 COSTS(000):$0
Identification of Cars Moved in Accordance with Order 13528
FORMS: NONE
OMB NO: 2130-0509 EXPIRATION DATE: 08/31/2003
RESPS:25,362 HOURS:9,467 COSTS(000):$30
State Safety Participation Regulations and Remedial Actions
FORMS: FRA-F-6180.10 FRA-F-6180.29 FRA-F-6180.29A FRA-F-6180.33
FRA-F-6180.61 FRA-F-6180.67 FRA-F-6180.68 FRA-F-6180.68A
FRA-F-6180.96 FRA-F-6180.96A
OMB NO: 2130-0511 EXPIRATION DATE: 03/31/2004
RESPS:1,200 HOURS:40 COSTS(000):$0
Designation of Qualified Persons
FORMS: NONE
OMB NO: 2130-0516 EXPIRATION DATE: 07/31/2003
RESPS:3,604,000 HOURS:240,267 COSTS(000):$0
Remotely Controlled Switch Operations
FORMS: NONE
OMB NO: 2130-0517 EXPIRATION DATE: 08/31/2005
RESPS:2,000 HOURS:6,000 COSTS(000):$8
Supplemental Qualifications Statement for Railroad Safety
Inspector Applicants
FORMS: FRA-F-120
OMB NO: 2130-0519 EXPIRATION DATE: 07/31/2003
RESPS:150,000 HOURS:10,833 COSTS(000):$1
Bad Order and Home Shop Card
FORMS: NONE
OMB NO: 2130-0520 EXPIRATION DATE: 07/31/2003
RESPS:35,000 HOURS:26,250 COSTS(000):$0
Stenciling Reporting Mark on Freight Cars
FORMS: NONE
OMB NO: 2130-0523 EXPIRATION DATE: 08/31/2003
RESPS:4 HOURS:8 COSTS(000):$0
Rear-End Marking Devices
FORMS: NONE
OMB NO: 2130-0524 EXPIRATION DATE: 11/30/2004
RESPS:8,786,542 HOURS:255,372 COSTS(000):$10
Railroad Communications (Formerly Radio Standards and Procedures)
FORMS: NONE
OMB NO: 2130-0525 EXPIRATION DATE: 08/31/2003
RESPS:28,776 HOURS:1,010 COSTS(000):$29
Certification of Glazing Materials
FORMS: FRA-F-6180.3
OMB NO: 2130-0526 EXPIRATION DATE: 06/30/2003
RESPS:360,124 HOURS:129,916 COSTS(000):$56
Control of Alcohol and Drug Use in Railroad Operations
FORMS: FRA-F-6180.73 6180.74 6180-94A 6180.94B
OMB NO: 2130-0527 EXPIRATION DATE: 07/31/2003
RESPS:120 HOURS:160 COSTS(000):$0
New Locomotive Certification (Noise Compliance Regulations)
FORMS: NONE
OMB NO: 2130-0529 EXPIRATION DATE: 07/31/2003
RESPS:3 HOURS:5 COSTS(000):$0
Disqualification Proceedings
FORMS: NONE
OMB NO: 2130-0533 EXPIRATION DATE: 06/30/2005
RESPS:165,420 HOURS:202,741 COSTS(000):$154
Qualifications for Locomotive Engineers
FORMS: NONE
OMB NO: 2130-0534 EXPIRATION DATE: 07/31/2003
RESPS:3,204 HOURS:601 COSTS(000):$0
Grade Crossing Signal System Safety
FORMS: FRA-F-6180.83
OMB NO: 2130-0535 EXPIRATION DATE: 08/31/2003
RESPS:6 HOURS:1 COSTS(000):$0
Bridge Worker Safety Rules
FORMS: NONE
OMB NO: 2130-0537 EXPIRATION DATE: 06/30/2003
RESPS:60 HOURS:155 COSTS(000):$5
Railroad Polic Officers
FORMS: NONE
OMB NO: 2130-0539 EXPIRATION DATE: 03/31/2004
RESPS:19,373,189 HOURS:588,570 COSTS(000):$3,051
Roadway Worker Protection: Roadway Maintenance Machine Safety
FORMS: NONE
OMB NO: 2130-0540 EXPIRATION DATE: 08/31/2003
RESPS:537,571 HOURS:5,797 COSTS(000):$3
Two-way End-of-Train Devices
FORMS: NONE
OMB NO: 2130-0544 EXPIRATION DATE: 06/30/2005
RESPS:5,076,058 HOURS:83,186 COSTS(000):$62
Passenger Equipment Safety Standards
FORMS: NONE
OMB NO: 2130-0545 EXPIRATION DATE: 05/31/2004
RESPS:35,363 HOURS:4,595 COSTS(000):$18
Passenger Train Emergency Preparedness
FORMS: NONE
OMB NO: 2130-0548 EXPIRATION DATE: 01/31/2006
RESPS:159 HOURS:5,881 COSTS(000):$151
Railroad Rehabilitation and Improvement Financing Program
FORMS: NONE
OMB NO: 2130-0550 EXPIRATION DATE: 09/30/2003
RESPS:1,120 HOURS:1,150 COSTS(000):$0
Rail-Equipment Accident/Incident Cost Analysis Study
FORMS: F6180.105
OMB NO: 2130-0551 EXPIRATION DATE: 12/31/2003
RESPS:8,135 HOURS:3,387 COSTS(000):$0
Regional Inspection Point Listing Forms
FORMS: FRA-F-6180.106 (A)-(E)
OMB NO: 2130-0552 EXPIRATION DATE: 06/30/2005
RESPS:124,800 HOURS:1,560 COSTS(000):$23
Locomotive Cab Sanitation Standards
FORMS: NONE
OMB NO: 2130-0553 EXPIRATION DATE: 09/30/2004
RESPS:15,058 HOURS:23,513 COSTS(000):$2
Positive Train Control
FORMS: NONE
OMB NO: 2130-0555 EXPIRATION DATE: 01/31/2005
RESPS:417 HOURS:622 COSTS(000):$2
Foreign Railroads Foreign-Based (FRFB) Employees Who Perform
Train or Dispatching Service in the United States
FORMS: NONE
OMB NO: 2130-0556 EXPIRATION DATE: 01/31/2006
RESPS:8 HOURS:36 COSTS(000):$0
U. S. Locational Requirement for Dispatching U.S. Rail Operations
FORMS: NONE
OMB NO: 2130-0557 EXPIRATION DATE: 03/31/2005
RESPS:79 HOURS:496 COSTS(000):$1
Safety Integration Plans
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
40 12,088,910,511 9,945,902 $13,250
Federal Transit Administration
OMB NO: 2132-0008 EXPIRATION DATE: 06/30/2005
RESPS:578 HOURS:238,136 COSTS(000):$0
49 U.S.C. Section 5335(a) and (b) National Transit Database
FORMS: 001 100 200 400
OMB NO: 2132-0500 EXPIRATION DATE: 05/31/2004
RESPS:111 HOURS:6,540 COSTS(000):$0
49 U.S.C. Section 5310-Capital Assistance Program for Elderly
Persons and Persons with Disabilities and Section 5311-
Nonurbanized Area Formula Program
FORMS: NONE
OMB NO: 2132-0502 EXPIRATION DATE: 12/31/2004
RESPS:198,466 HOURS:198,466 COSTS(000):$0
49 U.S.C. Section 5309 Capital Program and Section 5307
Urbanized Area Formula Progrm
FORMS: NONE
OMB NO: 2132-0529 EXPIRATION DATE: 03/31/2004
RESPS:101,339 HOURS:253,250 COSTS(000):$1,460
Metropolitan and Statewide Transportation Planning
FORMS: NONE
OMB NO: 2132-0540 EXPIRATION DATE: 07/31/2003
RESPS:200 HOURS:4,454 COSTS(000):$11
Title VI as it Applies to FTA Grant Programs
FORMS: NONE
OMB NO: 2132-0542 EXPIRATION DATE: 06/30/2003
RESPS:150 HOURS:4,500 COSTS(000):$0
Nondiscrimination as it Applies to FTA Grant Programs
FORMS: NONE
OMB NO: 2132-0543 EXPIRATION DATE: 12/31/2004
RESPS:1,656 HOURS:1,984 COSTS(000):$0
Charter Service Operations
FORMS: NONE
OMB NO: 2132-0544 EXPIRATION DATE: 04/30/2004
RESPS:3 HOURS:3,024 COSTS(000):$0
Pre-Award, Post-Delivery Review Requirements under Buy America
FORMS: NONE
OMB NO: 2132-0546 EXPIRATION DATE: 06/30/2003
RESPS:2,210 HOURS:13,940 COSTS(000):$0
49 U.S.C. Section 5312(a) Transit Research, Development,
Demonstration and Training Projects
FORMS: NONE
OMB NO: 2132-0549 EXPIRATION DATE: 06/30/2003
RESPS:104 HOURS:156 COSTS(000):$3
Technical Activities Form
FORMS: NONE
OMB NO: 2132-0550 EXPIRATION DATE: 06/30/2003
RESPS:15 HOURS:53 COSTS(000):$103
Bus Testing Program
FORMS: NONE
OMB NO: 2132-0555 EXPIRATION DATE: 04/30/2004
RESPS:750 HOURS:40,000 COSTS(000):$0
Americans with Disabilities Act
FORMS: NONE
OMB NO: 2132-0556 EXPIRATION DATE: 09/30/2003
RESPS:87,568 HOURS:10,113 COSTS(000):$0
Prevention of Prohibited Drug Use & Control of Alcohol Misuse in
Transit Operations (Was 2 separate information collections:
2132-0556 Prevention of Prohibited Drug Use in Transit Operations
FORMS: NONE
OMB NO: 2132-0558 EXPIRATION DATE: 11/30/2005
RESPS:160 HOURS:37,158 COSTS(000):$0
Rail Fixed Guideway Systems-State Safety Oversight
FORMS: NONE
OMB NO: 2132-0559 EXPIRATION DATE: 07/31/2005
RESPS:1,021 HOURS:511 COSTS(000):$0
Customer Service Surveys
FORMS: NONE
OMB NO: 2132-0560 EXPIRATION DATE: 08/31/2003
RESPS:1,770 HOURS:32,742 COSTS(000):$0
49 U.S.C. Section 5308 Clean Fuels Formula Grant Program
FORMS: NONE
OMB NO: 2132-0561 EXPIRATION DATE: 08/31/2004
RESPS:1 HOURS:47,200 COSTS(000):$0
49 CFR Part 611 Major Capital Investment Projects; Final Rule
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
17 396,102 892,227 $1,577
Maritime Administration
OMB NO: 2133-0005 EXPIRATION DATE: 01/31/2005
RESPS:198 HOURS:1,881 COSTS(000):$0
Uniform Financial Reporting Requirements
FORMS: MA-172
OMB NO: 2133-0006 EXPIRATION DATE: 07/31/2003
RESPS:100 HOURS:200 COSTS(000):$0
Request for Transfer of Ownership, Registry, and Flag, or
Charter, Lease, or Mortgage of U.S. Citizen Owned Documented
Vessels
FORMS: MA-29 MA-29A MA-29B
OMB NO: 2133-0007 EXPIRATION DATE: 07/31/2003
RESPS:25 HOURS:300 COSTS(000):$0
Maintenance and Repair Cumulative Summary
FORMS: MA-140
OMB NO: 2133-0010 EXPIRATION DATE: 06/30/2005
RESPS:2,500 HOURS:12,500 COSTS(000):$0
U.S. Merchant Marine Academy Candidate Application for Admission
FORMS: KP-2-65
OMB NO: 2133-0011 EXPIRATION DATE: 10/31/2004
RESPS:1,165 HOURS:626 COSTS(000):$0
War Risk Insurance - Applications and Related Information
FORMS: MA-355 MA-528 MA-742 MA-828 MA-942
OMB NO: 2133-0012 EXPIRATION DATE: 12/31/2004
RESPS:300 HOURS:1,500 COSTS(000):$0
Requirements for establishing U.S. Citizenship (46 CFR 355)
FORMS: NONE
OMB NO: 2133-0013 EXPIRATION DATE: 02/28/2006
RESPS:336 HOURS:168 COSTS(000):$0
Monthly Report of Ocean Shipments Moving under Export-Imported
Bank Financing
FORMS: MA-518
OMB NO: 2133-0018 EXPIRATION DATE: 08/31/2005
RESPS:21 HOURS:1,470 COSTS(000):$0
46 CFR Part 298-Title XI Obligation Guarantees
FORMS: MA-163 MA-163A
OMB NO: 2133-0024 EXPIRATION DATE: 12/31/2004
RESPS:8 HOURS:16 COSTS(000):$0
Subsidy Voucher - Operating Differential Subsidy (Bulk & Liner
Cargo Vessels
FORMS: MA-790 SF-1034
OMB NO: 2133-0025 EXPIRATION DATE: 01/31/2004
RESPS:32,480 HOURS:2,598 COSTS(000):$0
Automated Mutual-Assistance Vessel Rescue System (AMVER)
FORMS: CG-47960A(MA) (REV.8-88)
OMB NO: 2133-0027 EXPIRATION DATE: 01/31/2006
RESPS:140 HOURS:2,130 COSTS(000):$0
Capital Construction Fund and Exhibits
FORMS: NONE
OMB NO: 2133-0029 EXPIRATION DATE: 10/31/2005
RESPS:800 HOURS:400 COSTS(000):$0
Shipbuilding Orderbook and Shipyard Employment
FORMS: MA-832
OMB NO: 2133-0030 EXPIRATION DATE: 02/28/2005
RESPS:20,000 HOURS:100 COSTS(000):$0
Supplementary Training Course Application
FORMS: MA-823
OMB NO: 2133-0032 EXPIRATION DATE: 08/31/2005
RESPS:21 HOURS:189 COSTS(000):$0
Application for Construction Reserve Fund and Annual Statements
(CRF)
FORMS: NONE
OMB NO: 2133-0501 EXPIRATION DATE: 03/31/2006
RESPS:3 HOURS:150 COSTS(000):$0
Records Retention Schedule
FORMS: NONE
OMB NO: 2133-0503 EXPIRATION DATE: 02/28/2006
RESPS:22 HOURS:66 COSTS(000):$0
Inventory of American Intermodal Equipment
FORMS: NONE
OMB NO: 2133-0504 EXPIRATION DATE: 04/30/2005
RESPS:60 HOURS:60 COSTS(000):$0
Regulations for Making Excess or Surplus Federal Property
Available to the U.S. Merchant Marine Academy State Maritime
Academies
FORMS: NONE
OMB NO: 2133-0505 EXPIRATION DATE: 01/31/2004
RESPS:20 HOURS:20 COSTS(000):$0
Voluntary Tanker Agreement
FORMS: NONE
OMB NO: 2133-0506 EXPIRATION DATE: 05/31/2004
RESPS:1,500 HOURS:1,500 COSTS(000):$0
Merchant Marine Medals and Awards
FORMS: NONE
OMB NO: 2133-0509 EXPIRATION DATE: 03/31/2006
RESPS:2,300 HOURS:1,150 COSTS(000):$0
Maritime Administration Service Obligation Compliance Report and
Merchant Marine Reserve US Naval Reserve (USNR) Annual Report
FORMS: MA-930
OMB NO: 2133-0510 EXPIRATION DATE: 04/30/2005
RESPS:61 HOURS:21 COSTS(000):$0
Request for Waiver of Service Obligation; Request for Deferment
of Service Obligation; Application for Review
FORMS: MA-935 MA-936 MA-937
OMB NO: 2133-0511 EXPIRATION DATE: 04/30/2003
RESPS:92 HOURS:46 COSTS(000):$0
EUSC/Parent Company
FORMS: NONE
OMB NO: 2133-0514 EXPIRATION DATE: 03/31/2006
RESPS:175 HOURS:700 COSTS(000):$0
Determination of Fair and Reasonable Rates for Carriage of
Agricltural Cargoes on U.S. Commercial Vessels
FORMS: MA-1025 MA-1026 MA-172
OMB NO: 2133-0517 EXPIRATION DATE: 03/31/2006
RESPS:62 HOURS:46 COSTS(000):$0
Approval of Underwriters for Marine Hull Insurance
FORMS: NONE
OMB NO: 2133-0521 EXPIRATION DATE: 03/31/2005
RESPS:1 HOURS:1 COSTS(000):$0
Part 380, Subpart B-Application for Designation of Vessels as
American Great Lakes Vessels
FORMS: NONE
OMB NO: 2133-0522 EXPIRATION DATE: 02/28/2006
RESPS:150 HOURS:1,875 COSTS(000):$0
Seamen's Claims; Administrative Action and Litigation
FORMS: NONE
OMB NO: 2133-0524 EXPIRATION DATE: 01/31/2004
RESPS:30 HOURS:1,280 COSTS(000):$0
Port Facility Conveyance Information
FORMS: NONE
OMB NO: 2133-0525 EXPIRATION DATE: 07/31/2005
RESPS:132 HOURS:152 COSTS(000):$0
Application and Reporting Elements for participation in the
Martime Security Program, under Subtitle B, Title VI, Merchant
Marine Act, 1936
FORMS: NONE
OMB NO: 2133-0526 EXPIRATION DATE: 03/31/2006
RESPS:50 HOURS:50 COSTS(000):$0
Information to Determine Seamen's Reemployment Rights - National
Emergency
FORMS: NONE
OMB NO: 2133-0528 EXPIRATION DATE: 09/30/2003
RESPS:6,650 HOURS:256 COSTS(000):$0
Customer Service Surveys
FORMS: MA-1016 MA-1017 MA-1021
OMB NO: 2133-0529 EXPIRATION DATE: 11/30/2005
RESPS:100 HOURS:100 COSTS(000):$0
Application for Waiver of the Coastwise Trade Laws for Small
Passenger Vessels
FORMS: NONE
OMB NO: 2133-0530 EXPIRATION DATE: 03/31/2006
RESPS:500 HOURS:2,950 COSTS(000):$0
Eligibility of U.S.-flag Vessels 100 feet or Greater in
Registered Length to Obtain a Fishery Endorsement to the
Vessel's Documentation
FORMS: NONE
OMB NO: 2133-0532 EXPIRATION DATE: 07/31/2003
RESPS:40 HOURS:200 COSTS(000):$0
Voluntary Intermodal Sealift Agreement (VISA)
FORMS: MA-1020
OMB NO: 2133-0533 EXPIRATION DATE: 03/31/2004
RESPS:230 HOURS:115 COSTS(000):$0
"Intermodal Access to U.S. Ports Survey" "Intermodal Access to
U.S. Marine Terminals Survey"
FORMS: NONE
OMB NO: 2133-0534 EXPIRATION DATE: 07/31/2005
RESPS:45 HOURS:23 COSTS(000):$0
"Intermodal Access to Shallow Draft Ports and Terminals Survey"
FORMS: MA-1024B
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
35 70,317 34,839 $0
Research and Special Programs Administration
OMB NO: 2137-0014 EXPIRATION DATE: 01/31/2005
RESPS:132,600 HOURS:102,021 COSTS(000):$1,595,000
Cargo Tank Specification Requirements
FORMS: NONE
OMB NO: 2137-0018 EXPIRATION DATE: 07/31/2004
RESPS:86,100 HOURS:66,390 COSTS(000):$0
Inspection and Testing of Portable Tanks and Intermediate Bulk
Containers
FORMS: NONE
OMB NO: 2137-0022 EXPIRATION DATE: 09/30/2005
RESPS:153,287 HOURS:168,431 COSTS(000):$0
Testing, Inspection, and Marking Requirements for Cylinders
FORMS: NONE
OMB NO: 2137-0034 EXPIRATION DATE: 09/30/2005
RESPS:260,000,000 HOURS:6,861,111 COSTS(000):$0
"Hazardous Materials Shipping Papers & Emergency Response
Information"
FORMS: NONE
OMB NO: 2137-0039 EXPIRATION DATE: 10/31/2004
RESPS:20,600 HOURS:30,942 COSTS(000):$0
Hazardous Materials Incident Reports
FORMS: F-5800-1
OMB NO: 2137-0047 EXPIRATION DATE: 04/30/2005
RESPS:1,849 HOURS:51,011 COSTS(000):$0
Transportation of Hazardous Liquids by Pipeline: Recordkeeping
and Accident Reporting Requirements
FORMS: 7000-1
OMB NO: 2137-0048 EXPIRATION DATE: 04/30/2005
RESPS:150 HOURS:19,000 COSTS(000):$0
Recordkeeping for LNG Facilities (LNG)
FORMS: NONE
OMB NO: 2137-0049 EXPIRATION DATE: 04/30/2005
RESPS:22,700 HOURS:940,991 COSTS(000):$0
Recordkeeping for Gas Pipeline Operators
FORMS: NONE
OMB NO: 2137-0051 EXPIRATION DATE: 08/31/2003
RESPS:4,294 HOURS:4,219 COSTS(000):$0
Rulemaking, Exemption, and Preemption Requirements
FORMS: NONE
OMB NO: 2137-0510 EXPIRATION DATE: 01/31/2004
RESPS:21,319 HOURS:14,480 COSTS(000):$0
"Radioactive (RAM) Transportation Requirements"
FORMS: NONE
OMB NO: 2137-0522 EXPIRATION DATE: 06/30/2004
RESPS:3,960 HOURS:6,725 COSTS(000):$0
Incident and Annual Report for Gas Pipeline Operators
FORMS: 7100.01 7100.2 7100.1-1 7100.2-1
OMB NO: 2137-0542 EXPIRATION DATE: 10/31/2004
RESPS:18,200 HOURS:1,213 COSTS(000):$0
Flammable Cryogenic Liquids
FORMS: NONE
OMB NO: 2137-0557 EXPIRATION DATE: 12/31/2005
RESPS:11,074 HOURS:25,605 COSTS(000):$0
Approvals for Hazardous Materials
FORMS: NONE
OMB NO: 2137-0559 EXPIRATION DATE: 08/31/2003
RESPS:16,640 HOURS:2,759 COSTS(000):$0
(Rail Carriers and Tank Car Tank Requirements) Requirements for
Rail Tank Car Tanks--Transportation of Hazardous Materials by
Rail
FORMS: NONE
OMB NO: 2137-0572 EXPIRATION DATE: 09/30/2004
RESPS:15,000 HOURS:30,000 COSTS(000):$0
Testing Requirements for Non-Bulk Packaging
FORMS: NONE
OMB NO: 2137-0578 EXPIRATION DATE: 06/30/2004
RESPS:47 HOURS:282 COSTS(000):$0
Reporting on Safety Related Conditions on Gas Hazardous Liquid
Pipelines and LNG Facilities
FORMS: NONE
OMB NO: 2137-0579 EXPIRATION DATE: 05/31/2004
RESPS:2,419 HOURS:2,963 COSTS(000):$0
Drug and Alcohol Testing of Pipeline Operators
FORMS: NONE
OMB NO: 2137-0582 EXPIRATION DATE: 09/30/2004
RESPS:864,400 HOURS:14,409 COSTS(000):$0
Container Certification Statements
FORMS: NONE
OMB NO: 2137-0584 EXPIRATION DATE: 04/30/2005
RESPS:61 HOURS:3,660 COSTS(000):$0
Certification and Agreement Forms for the Gas and Hazardous
Liquid Pipeline Safety Program
FORMS: NONE
OMB NO: 2137-0586 EXPIRATION DATE: 09/30/2004
RESPS:1 HOURS:4,080 COSTS(000):$0
Hazardous Materials Public Sector Training and Planning Grants
FORMS: NONE
OMB NO: 2137-0589 EXPIRATION DATE: 01/31/2006
RESPS:147 HOURS:29,780 COSTS(000):$0
Response Plans for Onshore Pipelines
FORMS: NONE
OMB NO: 2137-0591 EXPIRATION DATE: 10/31/2004
RESPS:8,000 HOURS:10,560 COSTS(000):$0
Response Plans for Shipments of Oil
FORMS: NONE
OMB NO: 2137-0593 EXPIRATION DATE: 07/31/2005
RESPS:900,000 HOURS:20,000 COSTS(000):$0
Recordkeeping Requirements for Excess Flow Valves Customer
Notification
FORMS: NONE
OMB NO: 2137-0594 EXPIRATION DATE: 06/30/2005
RESPS:550,000 HOURS:9,167 COSTS(000):$0
Customer-Owned Service Lines
FORMS: NONE
OMB NO: 2137-0595 EXPIRATION DATE: 10/31/2004
RESPS:920,530 HOURS:200,615 COSTS(000):$0
Cargo Tank Motor Vehicles in Liquefied Compressed Gas Service
FORMS: NONE
OMB NO: 2137-0596 EXPIRATION DATE: 01/31/2004
RESPS:1,350 HOURS:40,500 COSTS(000):$0
Nation Pipeline Mapping System
FORMS: NONE
OMB NO: 2137-0598 EXPIRATION DATE: 04/30/2004
RESPS:50 HOURS:100 COSTS(000):$0
Incorporation by Reference of Industry Standard on Leak Detection
FORMS: NONE
OMB NO: 2137-0600 EXPIRATION DATE: 08/31/2005
RESPS:50,000 HOURS:466,667 COSTS(000):$29
Qualification of Pipeline Personnel
FORMS: NONE
OMB NO: 2137-0601 EXPIRATION DATE: 09/30/2005
RESPS:400 HOURS:2,400 COSTS(000):$0
Pipeline Safety Reports of Abandoned Underwater Pipelines
FORMS: NONE
OMB NO: 2137-0604 EXPIRATION DATE: 12/31/2003
RESPS:66 HOURS:245,980 COSTS(000):$0
Pipeline Integrity Management in High Consequence Areas
FORMS: NONE
OMB NO: 2137-0605 EXPIRATION DATE: 04/30/2005
RESPS:132 HOURS:501,000 COSTS(000):$0
Pipeline Integrity Management in High Consequence Areas less
than 500 miles
FORMS: NONE
OMB NO: 2137-0610 EXPIRATION DATE: 03/31/2006
RESPS:1 HOURS:2,845,724 COSTS(000):$0
Pipeline Integrity Management in High Consequence Areas Gas
Transmission Pipeline Operators
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
32 263,805,377 12,722,785 $1,595,029
Bureau of Transportation Statistics - Aviation
OMB NO: 2138-0004 EXPIRATION DATE: 11/30/2005
RESPS:75 HOURS:20 COSTS(000):$0
Submission of Audit Reports, Part 248
FORMS: NONE
OMB NO: 2138-0006 EXPIRATION DATE: 06/30/2003
RESPS:482 HOURS:710 COSTS(000):$55
Part 249 Preservation of Records
FORMS: NONE
OMB NO: 2138-0009 EXPIRATION DATE: 06/30/2005
RESPS:1,512 HOURS:1,720 COSTS(000):$25
Form 298-C Report of Financial and Operating Statistics for
Small Aircraft Operators
FORMS: 298-C
OMB NO: 2138-0013 EXPIRATION DATE: 06/30/2005
RESPS:8,000 HOURS:24,428 COSTS(000):$0
Report of Financial and Operating Statistics for Large
Certificated Air Carriers
FORMS: FORM-41
OMB NO: 2138-0016 EXPIRATION DATE: 06/30/2003
RESPS:24 HOURS:24 COSTS(000):$600
Report of Extension of Credit to Political Candidates
FORMS: FORM-183
OMB NO: 2138-0018 EXPIRATION DATE: 01/31/2004
RESPS:560 HOURS:2,200 COSTS(000):$0
Form 251 Report of Passengers Denied Confirmed Space
FORMS: BTS-FORM-251
OMB NO: 2138-0039 EXPIRATION DATE: 11/30/2005
RESPS:40 HOURS:26 COSTS(000):$0
Reporting Required for International Civil Aviation Organization
FORMS: NONE
OMB NO: 2138-0040 EXPIRATION DATE: 07/31/2005
RESPS:3,972 HOURS:24,180 COSTS(000):$90
Report of Traffic and Capacity Statistic-The T-100 System
FORMS: T-100 T-100(F)
OMB NO: 2138-0041 EXPIRATION DATE: 02/28/2005
RESPS:276 HOURS:1,908 COSTS(000):$0
Airline Service Quality Performance
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
9 14,941 55,216 $770
Bureau of Transportation Statistics
OMB NO: 2139-0001 EXPIRATION DATE: 09/30/2003
RESPS:160 HOURS:38,080 COSTS(000):$8,000
Passenger Origin-Destination Survey Report
FORMS: NONE
OMB NO: 2139-0002 EXPIRATION DATE: 01/31/2006
RESPS:4,000 HOURS:1,800 COSTS(000):$56
Quarterly Report of Class I Motor Carriers of Property (OMB
2139-0002)
FORMS: FORM-QFR
OMB NO: 2139-0004 EXPIRATION DATE: 01/31/2006
RESPS:3,000 HOURS:27,000 COSTS(000):$886
Annual Report of Class I and Class II Motor Carriers of Property
(OMB 2139-0004)
FORMS: FORM-M
OMB NO: 2139-0007 EXPIRATION DATE: 04/30/2004
RESPS:22,000 HOURS:8,700 COSTS(000):$0
Bureau of Transportation Statistics' Customer Satisfaction
Surveys Program
FORMS: NONE
OMB NO: 2139-0008 EXPIRATION DATE: 02/29/2004
RESPS:25,000 HOURS:13,750 COSTS(000):$0
American Travel Survey (ATS)
FORMS: NONE
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
5 54,160 89,330 $8,942
AGENCY TOTALS:
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
350 15,371,393,079 246,451,640 $2,581,438
Department of Veterans Affairs
OMB NO: 2900-0001 EXPIRATION DATE: 11/30/2003
RESPS:395,000 HOURS:592,500 COSTS(000):$0
Veteran's Application for Compensation and/or Pension
FORMS: 21-526
OMB NO: 2900-0002 EXPIRATION DATE: 05/31/2003
RESPS:104,440 HOURS:104,440 COSTS(000):$0
Income-Net Worth and Employment Statement
FORMS: 21-527
OMB NO: 2900-0003 EXPIRATION DATE: 12/31/2004
RESPS:300,000 HOURS:100,000 COSTS(000):$0
Application for Burial Benefits
FORMS: 21-530
OMB NO: 2900-0004 EXPIRATION DATE: 12/31/2005
RESPS:63,300 HOURS:79,125 COSTS(000):$0
Application for Dependency and Indemnity Compensation, Death
Pension and Accrued Benefits by a Surviving Spouse or Child
(Including Death Compensation if Applicable)
FORMS: 21-534
OMB NO: 2900-0005 EXPIRATION DATE: 04/30/2003
RESPS:20,880 HOURS:25,056 COSTS(000):$0
Application for Dependency and Indemnity Compensation by
parents(s) (Including Accrued Benfits and Death Compensation
When Applicable)
FORMS: 21-535
OMB NO: 2900-0006 EXPIRATION DATE: 09/30/2005
RESPS:2,400 HOURS:1,200 COSTS(000):$0
Application for Accrued Amouts of Veterans Benefits Payable to
Surviving Spouse, Child or Dependent Parents
FORMS: 21-614
OMB NO: 2900-0009 EXPIRATION DATE: 04/30/2005
RESPS:54,000 HOURS:13,500 COSTS(000):$0
Disabled Veterans Application for Vocational Rehabilitation
FORMS: 28-1900
OMB NO: 2900-0011 EXPIRATION DATE: 12/31/2004
RESPS:1,500 HOURS:875 COSTS(000):$0
Application for Reinstatement
FORMS: 29-352 29-353
OMB NO: 2900-0012 EXPIRATION DATE: 07/31/2004
RESPS:29,636 HOURS:4,939 COSTS(000):$0
Application for Cash Surrender or Policy Loan
FORMS: 29-1546 29-1546-1
OMB NO: 2900-0013 EXPIRATION DATE: 06/30/2003
RESPS:650,000 HOURS:162,500 COSTS(000):$0
Application for United States Flag for Burial Purposes
FORMS: 21-2008
OMB NO: 2900-0014 EXPIRATION DATE: 08/31/2005
RESPS:35,000 HOURS:2,917 COSTS(000):$0
Authorization and Certification of Entrance or Reentrance into
Rehabilitation and Certification of Status
FORMS: VA-28-1905
OMB NO: 2900-0016 EXPIRATION DATE: 12/31/2005
RESPS:8,100 HOURS:14,175 COSTS(000):$0
Claim for Disability Insurance Benefits
FORMS: 29-357
OMB NO: 2900-0017 EXPIRATION DATE: 10/31/2003
RESPS:24,868 HOURS:22,946 COSTS(000):$0
Court Appointed Fiduciarys Account (letter size), Federal
Fiduciary's Account, Account Book, and Court Appointed
Fiduciary's Account (legal size)
FORMS: 21-4706 21-4706B 21-4706C 21-4718
OMB NO: 2900-0018 EXPIRATION DATE: 04/30/2003
RESPS:11,100 HOURS:2,775 COSTS(000):$0
(1) Application for Accreditation as Service Organization
Representative, (2) Appointment of Individual as Claimant's
Representative
FORMS: VA-FORM-21 VA-FORM-22A
OMB NO: 2900-0020 EXPIRATION DATE: 09/30/2004
RESPS:83,500 HOURS:13,917 COSTS(000):$0
Designation of Beneficiary, Government Life Insurance
FORMS: VA-29-336
OMB NO: 2900-0021 EXPIRATION DATE: 05/31/2004
RESPS:279,000 HOURS:66,166 COSTS(000):$0
Notice of Default; Notice of Default and Intention to Foreclose;
Notice of Intention to Foreclose
FORMS: 26-6850 26-6850A 26-6851
OMB NO: 2900-0024 EXPIRATION DATE: 07/31/2005
RESPS:3,732 HOURS:622 COSTS(000):$0
Insurance Deduction Authorization
FORMS: 29-888
OMB NO: 2900-0027 EXPIRATION DATE: 06/30/2005
RESPS:100 HOURS:33 COSTS(000):$0
Application for Accrued Benefits by Veteran's Surviving Spouse,
Child, or Dependent Parent
FORMS: 21-551
OMB NO: 2900-0028 EXPIRATION DATE: 10/31/2005
RESPS:196,200 HOURS:22,700 COSTS(000):$0
a. Application of Service Reresentative for Placement on Mailing
List b. Request for and Consen to Release of Information from
Claimant's Records c. Requests to Corespondent for Identifing....
FORMS: VA-3215 VA-3288 VA-70-2
OMB NO: 2900-0029 EXPIRATION DATE: 07/31/2005
RESPS:172,500 HOURS:57,917 COSTS(000):$0
VA Forms 26-6705, Offer to Purchase and Contract of Sale, VA
Form 26-6705b, Credit Statement of Prospective Purchaser, VA
Form 26-6705d, Addendum to VA Form 26-6705 (Virginia)
FORMS: 26-6705 26-6705B 26-6705D
OMB NO: 2900-0031 EXPIRATION DATE: 09/30/2005
RESPS:600 HOURS:150 COSTS(000):$0
Veteran's Supplemental Application for Assistance in Acquiring
Specially Adapted Housing
FORMS: 26-4555C
OMB NO: 2900-0032 EXPIRATION DATE: 04/30/2005
RESPS:200,000 HOURS:50,000 COSTS(000):$0
Report and Certification of Loan Disbursement
FORMS: 26-1820
OMB NO: 2900-0034 EXPIRATION DATE: 10/31/2003
RESPS:30,000 HOURS:7,500 COSTS(000):$0
Trainee Request for Leave - Chapter 31, Title 38, U.S. Code
FORMS: 28-1905H
OMB NO: 2900-0036 EXPIRATION DATE: 03/31/2005
RESPS:10 HOURS:28 COSTS(000):$0
Statement of Disappearance
FORMS: VA-21-1775
OMB NO: 2900-0038 EXPIRATION DATE: 03/31/2005
RESPS:9,000 HOURS:3,000 COSTS(000):$0
Information from Remarried Widow(er)
FORMS: 21-4103
OMB NO: 2900-0041 EXPIRATION DATE: 12/31/2004
RESPS:31,500 HOURS:5,925 COSTS(000):$0
Compliance Inspection Report
FORMS: 26-1839
OMB NO: 2900-0042 EXPIRATION DATE: 10/31/2003
RESPS:32,895 HOURS:32,895 COSTS(000):$0
Statement of Accredited Representative in Appealed Case
FORMS: 646
OMB NO: 2900-0043 EXPIRATION DATE: 03/31/2005
RESPS:226,000 HOURS:56,500 COSTS(000):$0
Declaration of Status of Dependents
FORMS: 21-686C
OMB NO: 2900-0045 EXPIRATION DATE: 12/31/2004
RESPS:300,000 HOURS:60,000 COSTS(000):$0
VA Request for Determination of Reasonable Value
FORMS: 26-1805
OMB NO: 2900-0046 EXPIRATION DATE: 09/30/2004
RESPS:312 HOURS:78 COSTS(000):$0
Statement of Heirs for Payment of Credits Due Estate of Veteran
FORMS: FL29-596
OMB NO: 2900-0047 EXPIRATION DATE: 05/31/2005
RESPS:40,000 HOURS:30,000 COSTS(000):$0
Financial Statement
FORMS: 26-6807
OMB NO: 2900-0049 EXPIRATION DATE: 08/31/2005
RESPS:177,500 HOURS:37,792 COSTS(000):$0
Request for Approval of School Attendance - VA Form 21-674 and
VA Form 21-674c. School Attendance Report- VA Form 21-674b.
FORMS: 21-674 21-674B 21-674C
OMB NO: 2900-0051 EXPIRATION DATE: 10/31/2003
RESPS:228 HOURS:228 COSTS(000):$0
Quarterly Report of State Approving Agency Activities
FORMS: 22-7398
OMB NO: 2900-0052 EXPIRATION DATE: 06/30/2005
RESPS:180,000 HOURS:45,000 COSTS(000):$0
Report of Medical Examination for Disability Evaluation
FORMS: 21-2545
OMB NO: 2900-0055 EXPIRATION DATE: 06/30/2005
RESPS:1,000 HOURS:250 COSTS(000):$0
Request for Determination of Loan Guaranty Eligibility -
Unmarried Surviving Spouses
FORMS: 26-1817
OMB NO: 2900-0059 EXPIRATION DATE: 03/31/2005
RESPS:2,000 HOURS:4,000 COSTS(000):$0
Statement of Person Claiming to Have Stood in Relation of Parent
FORMS: VA-21-524
OMB NO: 2900-0060 EXPIRATION DATE: 08/31/2005
RESPS:85,850 HOURS:8,938 COSTS(000):$0
Claim for Life Insurance Proceeds (NSLI & USGLI)
FORMS: 29-4125 29-4125A 29-4125K
OMB NO: 2900-0061 EXPIRATION DATE: 12/31/2005
RESPS:1,000 HOURS:1,000 COSTS(000):$0
Request for Supplies
FORMS: 28-1905M
OMB NO: 2900-0064 EXPIRATION DATE: 07/31/2005
RESPS:750 HOURS:375 COSTS(000):$0
Application for Amounts Due Estates of Persons Entitled to
Benefits
FORMS: VA-FORM-21-609
OMB NO: 2900-0065 EXPIRATION DATE: 09/30/2004
RESPS:60,000 HOURS:15,000 COSTS(000):$0
Request for Employment Information in Connection with Claim for
Disability Benefits
FORMS: VA-21-4192
OMB NO: 2900-0066 EXPIRATION DATE: 09/30/2004
RESPS:5,167 HOURS:862 COSTS(000):$0
Request for Employment Information
FORMS: 29-459
OMB NO: 2900-0067 EXPIRATION DATE: 12/31/2005
RESPS:1,500 HOURS:375 COSTS(000):$0
Application for Automobile or Other Conveyance and Adaptive
Equipment (Under 38 U.S.C. 3901-3904)
FORMS: 21-4502
OMB NO: 2900-0068 EXPIRATION DATE: 07/31/2005
RESPS:4,250 HOURS:2,833 COSTS(000):$0
Application for Service-Disabled Insurance
FORMS: 29-4364 29-0151
OMB NO: 2900-0073 EXPIRATION DATE: 10/31/2003
RESPS:725,802 HOURS:120,967 COSTS(000):$0
Enrollment Certification
FORMS: 22-1999 22-1999-1 22-1999-2 22-1999-3
OMB NO: 2900-0074 EXPIRATION DATE: 12/31/2003
RESPS:120,300 HOURS:24,060 COSTS(000):$0
Request for Change of Program or Place of Training (Under
Chapters 30 and 32, Title 38, U.S. Code; Section 903 of Public
Law 96-342; or Chapter 1606, Title 10, U.S. Code)
FORMS: 22-1995
OMB NO: 2900-0075 EXPIRATION DATE: 06/30/2005
RESPS:752,000 HOURS:188,000 COSTS(000):$0
Statement in Support of Claim
FORMS: 21-4138
OMB NO: 2900-0080 EXPIRATION DATE: 10/31/2004
RESPS:480,100 HOURS:32,742 COSTS(000):$0
Claim for Payment of Cost of Unauthorized Medical Services;
Funeral Arrangements; Authority & Invoice for Travel by
Ambulance or other Hired Vehicle; Authorization & Invoice for
Medical....
FORMS: 10-583 10-2065 10-2511 10-7078
OMB NO: 2900-0085 EXPIRATION DATE: 07/31/2005
RESPS:39,782 HOURS:35,608 COSTS(000):$0
Appeal to Board of Veterans' Appeals, Withdrawal of Services by
a Representative, Filing of Representatives' Fee Agreements and
Motions for Review of Such Agreements, Motion for Review of......
FORMS: 9
OMB NO: 2900-0086 EXPIRATION DATE: 08/31/2005
RESPS:442,500 HOURS:110,625 COSTS(000):$0
Request for a Certificate of Eligibility for VA Home Loan
Benefits
FORMS: 26-1880
OMB NO: 2900-0089 EXPIRATION DATE: 03/31/2005
RESPS:40,000 HOURS:20,000 COSTS(000):$0
Statement of Dependency of Parent(s)
FORMS: 21-509
OMB NO: 2900-0090 EXPIRATION DATE: 11/30/2003
RESPS:30,000 HOURS:7,500 COSTS(000):$0
Application for Voluntary Service
FORMS: 10-7055
OMB NO: 2900-0091 EXPIRATION DATE: 03/31/2005
RESPS:5,985,000 HOURS:2,655,417 COSTS(000):$0
Application for Health Benefits
FORMS: VA-10-10EZ
OMB NO: 2900-0092 EXPIRATION DATE: 05/31/2004
RESPS:60,000 HOURS:30,000 COSTS(000):$0
Counseling Record - Personal Information
FORMS: 28-1902
OMB NO: 2900-0094 EXPIRATION DATE: 06/30/2005
RESPS:1,000 HOURS:250 COSTS(000):$0
Supplement to VA Forms 21-526, 21-534, and 21-535 (For
Philippine Claims)
FORMS: VA-21-4169
OMB NO: 2900-0095 EXPIRATION DATE: 03/31/2005
RESPS:25,000 HOURS:12,500 COSTS(000):$0
Pension Claim Questionnair for Farm Income
FORMS: VA-21-4165
OMB NO: 2900-0098 EXPIRATION DATE: 07/31/2003
RESPS:20,100 HOURS:10,050 COSTS(000):$0
Application for Survivors' and Dependents' Educational
Assistance (Under Chapter 35, Title 38 U.S.C.)
FORMS: 22-5490
OMB NO: 2900-0099 EXPIRATION DATE: 09/30/2004
RESPS:12,000 HOURS:3,000 COSTS(000):$0
Request for Change of Program or Place of Training Survivors'
and Dependents' Education Assistance (Under Provisions of
Chapter 35, Title 38 U.S.C.)
FORMS: VA-22-5495
OMB NO: 2900-0101 EXPIRATION DATE: 05/31/2005
RESPS:293,894 HOURS:146,947 COSTS(000):$0
Eligibility Verification Reports
FORMS: 21-0510 21-0511S 21-0511S-1 21-0511V 21-0511V-1 21-0512S
21-0512S-1 21-0512V 21-0512V-1 21-0513
OMB NO: 2900-0103 EXPIRATION DATE: 03/31/2005
RESPS:7,900 HOURS:1,975 COSTS(000):$0
Application for Dependency and Indemnity Compensation by Child
FORMS: VA-21-4183
OMB NO: 2900-0104 EXPIRATION DATE: 04/30/2003
RESPS:4,400 HOURS:2,200 COSTS(000):$0
Report of Accidental Injury in Support of Claim for Compensation
or Pension
FORMS: 21-4176
OMB NO: 2900-0105 EXPIRATION DATE: 03/31/2005
RESPS:13,200 HOURS:4,400 COSTS(000):$0
Statement of Witness to Accident
FORMS: 21-806
OMB NO: 2900-0107 EXPIRATION DATE: 12/31/2005
RESPS:4,316 HOURS:863 COSTS(000):$0
Certificate As To Assets
FORMS: 21-4709
OMB NO: 2900-0108 EXPIRATION DATE: 12/31/2005
RESPS:59,000 HOURS:29,500 COSTS(000):$0
Report of Income from Property or Business
FORMS: 21-4185
OMB NO: 2900-0110 EXPIRATION DATE: 07/31/2003
RESPS:4,082 HOURS:680 COSTS(000):$0
Application for Assumption Approval and/or Release From Personal
Liability to the Government on a Home Loan
FORMS: 26-6381
OMB NO: 2900-0111 EXPIRATION DATE: 10/31/2004
RESPS:9,000 HOURS:2,250 COSTS(000):$0
Statement of Purchaser or Owner Assuming Seller's Loan
FORMS: 26-6382
OMB NO: 2900-0112 EXPIRATION DATE: 08/31/2003
RESPS:7,000 HOURS:1,167 COSTS(000):$0
Statement of Holder or Servicer of Veteran's Loan
FORMS: 26-559
OMB NO: 2900-0113 EXPIRATION DATE: 09/30/2003
RESPS:6,200 HOURS:2,067 COSTS(000):$0
Application for Fee Personnel Designation
FORMS: 26-6681
OMB NO: 2900-0114 EXPIRATION DATE: 04/30/2005
RESPS:6,000 HOURS:3,000 COSTS(000):$0
Statement of Marital Relationship
FORMS: 21-4170
OMB NO: 2900-0115 EXPIRATION DATE: 06/30/2005
RESPS:2,400 HOURS:800 COSTS(000):$0
Supporting Statement Regarding Marriage
FORMS: 21-4171
OMB NO: 2900-0116 EXPIRATION DATE: 05/31/2005
RESPS:1,664 HOURS:416 COSTS(000):$0
Notice of Department of Veterans Affairs of Veteran or
Beneficiary Incarcerated in Penal Institution
FORMS: 21-4193
OMB NO: 2900-0117 EXPIRATION DATE: 07/31/2004
RESPS:12,500 HOURS:3,125 COSTS(000):$0
Inquiry Concerning Application for Employment
FORMS: VAFL-5-127
OMB NO: 2900-0118 EXPIRATION DATE: 07/31/2004
RESPS:20,600 HOURS:3,433 COSTS(000):$0
Transfer of Scholastic Credit (Schools)
FORMS: 22-315
OMB NO: 2900-0119 EXPIRATION DATE: 10/31/2005
RESPS:20,277 HOURS:4,055 COSTS(000):$0
Report of Treatment in Hospital
FORMS: 29-551
OMB NO: 2900-0120 EXPIRATION DATE: 05/31/2005
RESPS:20,277 HOURS:5,069 COSTS(000):$0
Report of Treatment of Attending Physician
FORMS: FL-29-551A
OMB NO: 2900-0121 EXPIRATION DATE: 03/31/2006
RESPS:244 HOURS:61 COSTS(000):$0
Obtaining Supplemental Information from Hospital or Doctor
FORMS: 29-551B
OMB NO: 2900-0129 EXPIRATION DATE: 04/30/2005
RESPS:6,570 HOURS:548 COSTS(000):$0
Supplemental Disability Report
FORMS: FL-29-30A
OMB NO: 2900-0130 EXPIRATION DATE: 03/31/2005
RESPS:40,000 HOURS:20,000 COSTS(000):$0
Status of Loan Account - Foreclosure or Other Liquidation
FORMS: 26-567
OMB NO: 2900-0131 EXPIRATION DATE: 07/31/2005
RESPS:9,000 HOURS:3,000 COSTS(000):$0
Request for Supplemental Information on Medical and Nonmedical
Applications
FORMS: FL-29-615
OMB NO: 2900-0132 EXPIRATION DATE: 03/31/2006
RESPS:1,500 HOURS:250 COSTS(000):$0
Veteran's Application in Acquiring Specially Adapted Housing or
Special Home Adaptation Grant
FORMS: 26-4555
OMB NO: 2900-0133 EXPIRATION DATE: 09/30/2004
RESPS:700 HOURS:175 COSTS(000):$0
Application for Amounts on Deposit for Deceased Veteran
FORMS: VA-21-6898
OMB NO: 2900-0138 EXPIRATION DATE: 11/30/2004
RESPS:22,800 HOURS:5,700 COSTS(000):$0
Request for Details of Expenses
FORMS: 21-8049
OMB NO: 2900-0139 EXPIRATION DATE: 03/31/2005
RESPS:1,200 HOURS:300 COSTS(000):$0
Notice - Payment Not Applied
FORMS: 29-4499A
OMB NO: 2900-0143 EXPIRATION DATE: 10/31/2004
RESPS:100 HOURS:33 COSTS(000):$0
Offer To Rent On Month-To-Month Basis and Credit Statement Of
Prospective Tenant
FORMS: 26-6725
OMB NO: 2900-0144 EXPIRATION DATE: 10/31/2004
RESPS:200,000 HOURS:20,000 COSTS(000):$0
HUD/VA Addendum to Uniform Residential Loan Application and
Uniform Residential Loan Application
FORMS: 26-1802A FREDDIEMAC-65 FANNIEMAE-1003
OMB NO: 2900-0149 EXPIRATION DATE: 03/31/2005
RESPS:4,000 HOURS:1,125 COSTS(000):$0
Application for Conversion
FORMS: 29-0152
OMB NO: 2900-0153 EXPIRATION DATE: 04/30/2005
RESPS:60,000 HOURS:15,000 COSTS(000):$0
Disability Benefits Questionnaire
FORMS: 29-8313 29-8313-1
OMB NO: 2900-0154 EXPIRATION DATE: 01/31/2004
RESPS:126,093 HOURS:73,554 COSTS(000):$0
Application for VA Education Benefits
FORMS: 22-1990
OMB NO: 2900-0156 EXPIRATION DATE: 04/30/2003
RESPS:824,588 HOURS:68,716 COSTS(000):$0
Notice of Change in Student Status
FORMS: 22-1999B
OMB NO: 2900-0159 EXPIRATION DATE: 03/31/2005
RESPS:8,600 HOURS:2,867 COSTS(000):$0
Application for Payment of Matured Endowment
FORMS: 29-5767
OMB NO: 2900-0160 EXPIRATION DATE: 09/30/2003
RESPS:55,993 HOURS:14,245 COSTS(000):$0
Title 38, CFR Part 51 and Title 38, CFR Part 52
FORMS: VA-10-10SH VA-10-3567 VA-10-5588 VA-10-0143 VA-10-0143A
VA-10-0144 VA-10-0144A
OMB NO: 2900-0161 EXPIRATION DATE: 05/31/2005
RESPS:96,400 HOURS:48,200 COSTS(000):$0
Medical Expense Report
FORMS: 21-8416
OMB NO: 2900-0162 EXPIRATION DATE: 07/31/2004
RESPS:12,100 HOURS:6,050 COSTS(000):$0
Monthly Certification of Flight Training
FORMS: 22-6553C
OMB NO: 2900-0165 EXPIRATION DATE: 07/31/2003
RESPS:41,800 HOURS:41,800 COSTS(000):$0
Financial Status Report
FORMS: 20-5655
OMB NO: 2900-0166 EXPIRATION DATE: 05/31/2005
RESPS:15,400 HOURS:1,284 COSTS(000):$0
Application for Ordinary Life Insurance and Information about
Modified Life
FORMS: 29-8485 29-8485A 29-8700A-E 29-8701A-E
OMB NO: 2900-0171 EXPIRATION DATE: 01/31/2006
RESPS:2,400 HOURS:1,200 COSTS(000):$0
Application and Enrollment Certification for Individualized
Tutorial Assistance
FORMS: 22-1990T
OMB NO: 2900-0176 EXPIRATION DATE: 03/31/2004
RESPS:12,000 HOURS:3,000 COSTS(000):$30
Monthly Record of Training and Wages
FORMS: 28-1905C
OMB NO: 2900-0178 EXPIRATION DATE: 03/31/2006
RESPS:120,600 HOURS:20,100 COSTS(000):$0
Monthly Certification of On-The-Job and Apprenticeship Training
FORMS: 22-6553D 22-6553D-1
OMB NO: 2900-0179 EXPIRATION DATE: 03/31/2005
RESPS:28 HOURS:14 COSTS(000):$0
Application for Change of Permanent Plan (Medical)
FORMS: 29-1549
OMB NO: 2900-0180 EXPIRATION DATE: 08/31/2003
RESPS:1 HOURS:124 COSTS(000):$0
Compliance Report of Proprietary Institutions
FORMS: 27-4274
OMB NO: 2900-0188 EXPIRATION DATE: 10/31/2004
RESPS:519,844 HOURS:37,079 COSTS(000):$0
Claim, Authorization and Invoice for Prosthetic Items and
Services
FORMS: 10-90 10-426 10-0103 10-1394 10-2421 10-2520 10-2914
OMB NO: 2900-0198 EXPIRATION DATE: 07/31/2003
RESPS:6,720 HOURS:1,120 COSTS(000):$0
Application for Annual Clothing Allowance
FORMS: 21-8678
OMB NO: 2900-0205 EXPIRATION DATE: 03/31/2006
RESPS:166,342 HOURS:75,471 COSTS(000):$0
Application for Employment and Appraisal of Applicant for Title
38 Positions
FORMS: 10-2850 10-2850A 10-2850B 10-2850C 10-341A
OMB NO: 2900-0208 EXPIRATION DATE: 03/31/2006
RESPS:18,205 HOURS:4,591 COSTS(000):$0
Daily Log-Formal Contract and Architect-Engineer Fee Proposal
FORMS: 10-6131 10-6298
OMB NO: 2900-0209 EXPIRATION DATE: 09/30/2003
RESPS:80,000 HOURS:9,184 COSTS(000):$0
Application for Work-Study Allowance, Student Work-Study
Agreement (Student Services), Extended Student Work-Study
Agreement, Work-Study Agreement (Student Services)
FORMS: 22-8691 8692 8692A 8692B
OMB NO: 2900-0212 EXPIRATION DATE: 09/30/2004
RESPS:450 HOURS:113 COSTS(000):$0
Veterans Mortgage Life Insurance Statement
FORMS: 29-8636
OMB NO: 2900-0215 EXPIRATION DATE: 03/31/2005
RESPS:22,600 HOURS:3,767 COSTS(000):$0
Request for Information to make Direct Payment to Child Reaching
Majority
FORMS: 21-863
OMB NO: 2900-0216 EXPIRATION DATE: 06/30/2005
RESPS:3,750 HOURS:1,875 COSTS(000):$0
Application for Reimbursement from Accrued Amounts Due a
Deceased Beneficiary
FORMS: 21-601
OMB NO: 2900-0219 EXPIRATION DATE: 03/31/2004
RESPS:381,000 HOURS:63,000 COSTS(000):$0
CHAMPVA Benefits - Application, Claim, OHI, Potential Liability
and Spina Bifida Benefits
FORMS: 10-10D 10-7959A 10-7959C 10-7959D
OMB NO: 2900-0222 EXPIRATION DATE: 04/30/2004
RESPS:334,000 HOURS:83,500 COSTS(000):$0
Application for Standard Government Headstone or Marker for
Installation in Private or State Veterans' Cemetery
FORMS: 40-1330
OMB NO: 2900-0227 EXPIRATION DATE: 06/30/2003
RESPS:278,062 HOURS:49,099 COSTS(000):$0
Nation-wide Customer Satisfaction Surveys
FORMS: 10-0142B 10-0142C 10-1465-1 10-1465-3 10-1465-7 10-1465-9
10-5387
OMB NO: 2900-0249 EXPIRATION DATE: 08/31/2004
RESPS:65,000 HOURS:27,083 COSTS(000):$0
Loan Service Report
FORMS: 26-6808
OMB NO: 2900-0251 EXPIRATION DATE: 11/30/2005
RESPS:175,000 HOURS:29,167 COSTS(000):$0
Present Status of Loan
FORMS: 26-8778
OMB NO: 2900-0252 EXPIRATION DATE: 12/31/2004
RESPS:120 HOURS:50 COSTS(000):$0
Application for Authority to Close Loans on an Automatic Basis -
Nonsupervised Lenders
FORMS: 26-8736
OMB NO: 2900-0253 EXPIRATION DATE: 12/31/2004
RESPS:3,000 HOURS:1,000 COSTS(000):$0
Nonsuperivsed Lender's Nomination and Recommendation of Credit
Underwriter
FORMS: 26-8736A
OMB NO: 2900-0260 EXPIRATION DATE: 10/31/2004
RESPS:326,000 HOURS:10,867 COSTS(000):$0
Request for and Consent to Release of Medical Records Protected
by 38 U.S.C. 7332
FORMS: 10-5345
OMB NO: 2900-0261 EXPIRATION DATE: 03/31/2005
RESPS:50,000 HOURS:8,333 COSTS(000):$0
Application for Refund of Educational Contributions
FORMS: 24-5281
OMB NO: 2900-0262 EXPIRATION DATE: 10/31/2003
RESPS:2,500 HOURS:417 COSTS(000):$0
Designation of Certifying Official
FORMS: 22-8794
OMB NO: 2900-0265 EXPIRATION DATE: 10/31/2003
RESPS:5,000 HOURS:417 COSTS(000):$0
Application for Counseling
FORMS: 28-8832
OMB NO: 2900-0270 EXPIRATION DATE: 06/30/2005
RESPS:5,000 HOURS:3,750 COSTS(000):$0
Financial Counseling Statement
FORMS: 26-8844
OMB NO: 2900-0276 EXPIRATION DATE: 11/30/2003
RESPS:124 HOURS:186 COSTS(000):$0
Manufactured Home Appraisal Report
FORMS: 26-8712
OMB NO: 2900-0300 EXPIRATION DATE: 07/31/2004
RESPS:75 HOURS:25 COSTS(000):$0
Veterans Application for Assistance in Acquiring Special Housing
Adaptations
FORMS: 26-4555D
OMB NO: 2900-0317 EXPIRATION DATE: 09/30/2004
RESPS:2,400 HOURS:200 COSTS(000):$0
Request for Identifying Information Re: Veteran's Loan Records
FORMS: 26-626
OMB NO: 2900-0319 EXPIRATION DATE: 10/31/2003
RESPS:16,676 HOURS:1,390 COSTS(000):$0
Fiduciary Agreement
FORMS: 21-4703
OMB NO: 2900-0320 EXPIRATION DATE: 08/31/2005
RESPS:10,000 HOURS:5,000 COSTS(000):$0
Escrow Agreement for Postponed Exterior Onsite Information
FORMS: 26-1849
OMB NO: 2900-0321 EXPIRATION DATE: 06/30/2003
RESPS:325,000 HOURS:27,083 COSTS(000):$0
Appointment of Veterans Service Organization as Claimant's
Representatives
FORMS: 21-22
OMB NO: 2900-0324 EXPIRATION DATE: 07/31/2005
RESPS:1,440 HOURS:1,080 COSTS(000):$0
Supplemental Physical Examination Reports
FORMS: 29-8146 29-8158 29-8160
OMB NO: 2900-0325 EXPIRATION DATE: 07/31/2004
RESPS:21,353 HOURS:1,779 COSTS(000):$0
Certificate of Delivery of Advance Payment and Enrollment
FORMS: 22-1999V
OMB NO: 2900-0335 EXPIRATION DATE: 03/31/2004
RESPS:43,000 HOURS:14,333 COSTS(000):$0
Dental Record Authorization and Invoice for Outpatient Services
FORMS: 10-2570D
OMB NO: 2900-0342 EXPIRATION DATE: 08/31/2004
RESPS:600 HOURS:450 COSTS(000):$0
Application and On-the-Job Training Agreement and Standards and
Employer's Application to Provide Training
FORMS: 22-8864 22-8865
OMB NO: 2900-0353 EXPIRATION DATE: 11/30/2003
RESPS:10,617 HOURS:1,780 COSTS(000):$0
Certification of Lessons Completed
FORMS: 22-6553B 22-6553B-1
OMB NO: 2900-0355 EXPIRATION DATE: 03/31/2005
RESPS:56,000 HOURS:9,333 COSTS(000):$0
Verification of Pursuit of Course (Leading to a Standard College
Degree)
FORMS: VA-22-6553
OMB NO: 2900-0358 EXPIRATION DATE: 08/31/2003
RESPS:16,500 HOURS:8,250 COSTS(000):$0
Supplemental Information for Change of Program or Reenrollment
After Unsatisfactory Attendance, Conduct or Progress
FORMS: 22-8873
OMB NO: 2900-0362 EXPIRATION DATE: 08/31/2005
RESPS:26,806 HOURS:26,139 COSTS(000):$0
Claim Under Loan Guaranty, Supplemental Claim Form - Adjustable
Rate Mortgages
FORMS: VA-26-1874 VA-26-1874A
OMB NO: 2900-0365 EXPIRATION DATE: 06/30/2004
RESPS:329 HOURS:33 COSTS(000):$0
Request for Disinterment
FORMS: 40-4970
OMB NO: 2900-0368 EXPIRATION DATE: 09/30/2005
RESPS:3,600 HOURS:1,800 COSTS(000):$0
Monthly Statement of Wages to Trainee
FORMS: 28-1917
OMB NO: 2900-0376 EXPIRATION DATE: 03/31/2004
RESPS:5,500 HOURS:1,833 COSTS(000):$0
Agent Orange Registry Codesheet
FORMS: 10-9009
OMB NO: 2900-0377 EXPIRATION DATE: 02/29/2004
RESPS:842 HOURS:421 COSTS(000):$0
Claim for Repurchase of Loan
FORMS: VA/FORM26-8084
OMB NO: 2900-0379 EXPIRATION DATE: 11/30/2003
RESPS:164,000 HOURS:13,667 COSTS(000):$0
Time Record (Work-Study Program)
FORMS: 22-8690
OMB NO: 2900-0381 EXPIRATION DATE: 03/31/2006
RESPS:25,000 HOURS:4,167 COSTS(000):$0
Notice of Election to Convey and/or Invoice for Transfer of
Property
FORMS: 26-8903
OMB NO: 2900-0383 EXPIRATION DATE: 09/30/2004
RESPS:12 HOURS:6 COSTS(000):$0
Application for Educational Assistance Test Program Benefits
(Section 901, PL 96-342)
FORMS: 22-8889
OMB NO: 2900-0386 EXPIRATION DATE: 10/31/2003
RESPS:50,000 HOURS:8,333 COSTS(000):$0
Interest Rate Reduction Refinancing Loan Worksheet
FORMS: 26-8923
OMB NO: 2900-0387 EXPIRATION DATE: 09/30/2004
RESPS:195,817 HOURS:16,318 COSTS(000):$0
Request for Verification of Deposit
FORMS: VA-26-8497A
OMB NO: 2900-0390 EXPIRATION DATE: 07/31/2005
RESPS:7,500 HOURS:2,500 COSTS(000):$0
Application of Surviving Spouse or Child for REPS Benefits
(Restored Entitlement Program for Survivors)
FORMS: 21-8924
OMB NO: 2900-0393 EXPIRATION DATE: 03/31/2005
RESPS:10,650 HOURS:10,650 COSTS(000):$0
Department of Veterans Affairs Acquisition Regulation (VAAR)
Part 813
FORMS: NONE
OMB NO: 2900-0394 EXPIRATION DATE: 04/30/2005
RESPS:1,200 HOURS:300 COSTS(000):$0
Certification of School Attendance - REPS
FORMS: 21-8926
OMB NO: 2900-0399 EXPIRATION DATE: 12/31/2005
RESPS:5,300 HOURS:1,767 COSTS(000):$0
Student Beneficiary Report -- REPS
FORMS: 21-8938
OMB NO: 2900-0404 EXPIRATION DATE: 03/31/2005
RESPS:24,000 HOURS:18,000 COSTS(000):$0
Veteran's Application for Increased Compensation Based on
Individual Unemployability
FORMS: 21-8940
OMB NO: 2900-0405 EXPIRATION DATE: 07/31/2005
RESPS:2,200 HOURS:550 COSTS(000):$0
REPS Annual Eligibility Report
FORMS: 21-8941
OMB NO: 2900-0406 EXPIRATION DATE: 02/29/2004
RESPS:75,000 HOURS:6,250 COSTS(000):$0
Verification of a Benefit-Related Indebtedness
FORMS: 26-8937
OMB NO: 2900-0408 EXPIRATION DATE: 10/31/2005
RESPS:110 HOURS:36 COSTS(000):$0
Manufactured Home Loan Claim Under Loan Guaranty (Manufactured
Home Unit Only)--Manufactured Home Loan Claim Under Loan
Guaranty (Combination Loan - Manufactured Home Unit & Lot/Lot
Only)
FORMS: 26-8629 26-8630
OMB NO: 2900-0418 EXPIRATION DATE: 03/31/2005
RESPS:1,600 HOURS:1,030 COSTS(000):$0
VAAR Sections 809.106-1 and 809.504(d) and VAAR Clause 852.209-70
FORMS: NONE
OMB NO: 2900-0422 EXPIRATION DATE: 03/31/2005
RESPS:3,534 HOURS:4,802 COSTS(000):$0
VAAR Clauses 852-236-72, 852.236-81, 852.236-82, 852.236-83,
852.236-84, and 852.236-88
FORMS: NONE
OMB NO: 2900-0427 EXPIRATION DATE: 11/30/2003
RESPS:50 HOURS:50 COSTS(000):$0
Former POW Medical History
FORMS: 10-0048
OMB NO: 2900-0432 EXPIRATION DATE: 02/29/2004
RESPS:60,000 HOURS:1 COSTS(000):$0
Invitation, Bid, and/or Acceptance or Authorization
FORMS: 26-6724
OMB NO: 2900-0442 EXPIRATION DATE: 10/31/2004
RESPS:102,000 HOURS:17,000 COSTS(000):$0
Request for Armed Forces Separation Records from Veteran
FORMS: FL-21-80E
OMB NO: 2900-0455 EXPIRATION DATE: 09/30/2004
RESPS:228 HOURS:247 COSTS(000):$0
Equal Opportunity Compliance Review Report and Supplement to
Equal Opportunity Compliance Review Report
FORMS: 20-8734 20-8734A
OMB NO: 2900-0458 EXPIRATION DATE: 12/31/2005
RESPS:70,000 HOURS:11,667 COSTS(000):$0
Certification of School Attendance or Termination
FORMS: 21-8960 21-8960-1
OMB NO: 2900-0459 EXPIRATION DATE: 11/30/2003
RESPS:22,000 HOURS:44,000 COSTS(000):$0
Property Management Consolidated Invoice
FORMS: 26-8974
OMB NO: 2900-0460 EXPIRATION DATE: 02/28/2006
RESPS:185,000 HOURS:30,833 COSTS(000):$0
Request for Verification of Employment
FORMS: 26-8497
OMB NO: 2900-0463 EXPIRATION DATE: 06/30/2005
RESPS:21,000 HOURS:3,500 COSTS(000):$0
Notice of Waiver of VA Compensation or Pension to Receive
Military Pay and Allowances
FORMS: 21-8951 21-8951-2
OMB NO: 2900-0465 EXPIRATION DATE: 01/31/2004
RESPS:2,190,000 HOURS:146,000 COSTS(000):$0
Student Verification of Enrollment
FORMS: 22-8979
OMB NO: 2900-0466 EXPIRATION DATE: 10/31/2003
RESPS:23,700 HOURS:1,185 COSTS(000):$0
Certificate of Balance on Deposit and Authorization to Disclose
Financial Records
FORMS: 21-4178A
OMB NO: 2900-0469 EXPIRATION DATE: 05/31/2005
RESPS:2,078 HOURS:1,039 COSTS(000):$0
Certificate Showing Residence and Heirs of Dec. Vet. or Bene.
FORMS: 29-541
OMB NO: 2900-0474 EXPIRATION DATE: 12/31/2004
RESPS:200,000 HOURS:6,667 COSTS(000):$0
A Computer Generated Funding Fee Receipt
FORMS: NONE
OMB NO: 2900-0492 EXPIRATION DATE: 07/31/2005
RESPS:3,000 HOURS:1,500 COSTS(000):$0
VA Matic Authorization
FORMS: 29-0532-1
OMB NO: 2900-0495 EXPIRATION DATE: 10/31/2004
RESPS:34,500 HOURS:2,875 COSTS(000):$0
Marital Status Questionnaire
FORMS: 21-0537
OMB NO: 2900-0500 EXPIRATION DATE: 05/31/2005
RESPS:84,500 HOURS:14,083 COSTS(000):$0
Status of Dependents Questionnaire
FORMS: 21-0538
OMB NO: 2900-0501 EXPIRATION DATE: 07/31/2005
RESPS:540 HOURS:45 COSTS(000):$0
Veterans Mortgage Protection Insurance
FORMS: 29-0543
OMB NO: 2900-0503 EXPIRATION DATE: 06/30/2005
RESPS:240 HOURS:240 COSTS(000):$0
Veterans Mortgage Life Insurance Change of Address Statement
FORMS: 29-0563
OMB NO: 2900-0510 EXPIRATION DATE: 06/30/2005
RESPS:25,000 HOURS:18,750 COSTS(000):$0
Application for Exclusion of Children's Income
FORMS: 21-0571
OMB NO: 2900-0518 EXPIRATION DATE: 05/31/2004
RESPS:114,000 HOURS:15,000 COSTS(000):$0
Income Verification
FORMS: 21-0161A
OMB NO: 2900-0519 EXPIRATION DATE: 09/30/2005
RESPS:2,025 HOURS:1,519 COSTS(000):$0
Locality Pay System for Nurses and Other Health Care Personnel
FORMS: 10-0132
OMB NO: 2900-0521 EXPIRATION DATE: 10/31/2004
RESPS:300,000 HOURS:1 COSTS(000):$0
Credit Underwriting Standards and Procedures for Processing VA
Guaranteed Loans
FORMS: NONE
OMB NO: 2900-0523 EXPIRATION DATE: 04/30/2004
RESPS:200,000 HOURS:100,000 COSTS(000):$0
Loan Analysis
FORMS: 26-6393
OMB NO: 2900-0524 EXPIRATION DATE: 10/31/2003
RESPS:1,800 HOURS:300 COSTS(000):$0
VA Police Officer Pre-Employment Screening Checklist
FORMS: 0120
OMB NO: 2900-0525 EXPIRATION DATE: 09/30/2004
RESPS:5,000 HOURS:1,250 COSTS(000):$0
VA MATIC Change
FORMS: 29-0165
OMB NO: 2900-0539 EXPIRATION DATE: 09/30/2004
RESPS:10,000 HOURS:3,333 COSTS(000):$0
Application for Supplemental Service Disabled Veterans Insurance
FORMS: 29-0188 29-0189 29-0190
OMB NO: 2900-0545 EXPIRATION DATE: 08/31/2005
RESPS:10,000 HOURS:7,500 COSTS(000):$0
Report of Medical, Legal, and Other Expenses Incident to
Recovery for Injury or Death
FORMS: 21-8416B
OMB NO: 2900-0546 EXPIRATION DATE: 08/31/2004
RESPS:18,000 HOURS:3,000 COSTS(000):$0
Gravesite Reservation Survey (2 Year)
FORMS: FL-40-40
OMB NO: 2900-0548 EXPIRATION DATE: 12/31/2005
RESPS:6,000 HOURS:600 COSTS(000):$0
Generic Clearance for Board of Veterans' Appeals Customer
Satisfaction with Hearing Survey
FORMS: 0745
OMB NO: 2900-0554 EXPIRATION DATE: 04/30/2004
RESPS:1,100 HOURS:3,527 COSTS(000):$0
Homeless Providers Grant and Per Diem Program
FORMS: 10-0361
OMB NO: 2900-0556 EXPIRATION DATE: 09/30/2005
RESPS:243,000 HOURS:101,250 COSTS(000):$0
Advanced Directive - Living Will and Durable Power of Attorney
FORMS: 10-0137
OMB NO: 2900-0559 EXPIRATION DATE: 06/30/2004
RESPS:65 HOURS:65 COSTS(000):$0
State Cemetery Data
FORMS: 40-0241
OMB NO: 2900-0564 EXPIRATION DATE: 07/31/2003
RESPS:198,000 HOURS:6,600 COSTS(000):$0
Direct Deposit Enrollment
FORMS: 24-0296
OMB NO: 2900-0565 EXPIRATION DATE: 08/31/2003
RESPS:40,000 HOURS:20,000 COSTS(000):$0
State Application for Interment Allowance Under 38 U.S.C.
FORMS: 21-530A
OMB NO: 2900-0567 EXPIRATION DATE: 02/29/2004
RESPS:38,952 HOURS:1,298 COSTS(000):$0
PMC Insert
FORMS: 40-0247
OMB NO: 2900-0568 EXPIRATION DATE: 08/31/2005
RESPS:7,600 HOURS:1,900 COSTS(000):$0
Submission of School Catalog to the State Approving Agency
FORMS: NONE
OMB NO: 2900-0569 EXPIRATION DATE: 12/31/2003
RESPS:195,966 HOURS:26,810 COSTS(000):$0
VA Voluntary Customer Surveys to Implement E.O. 12862
FORMS: NONE
OMB NO: 2900-0570 EXPIRATION DATE: 05/31/2003
RESPS:338,780 HOURS:75,069 COSTS(000):$0
Generic Veterans Health Administration Customer Satisfaction
Surveys
FORMS: NONE
OMB NO: 2900-0571 EXPIRATION DATE: 10/31/2003
RESPS:21,400 HOURS:9,496 COSTS(000):$0
Generic Clearance for NCA, OFM, and IG Customer Satisfaction
Surveys
FORMS: NONE
OMB NO: 2900-0572 EXPIRATION DATE: 05/31/2004
RESPS:2,000 HOURS:335 COSTS(000):$0
Application for Spina Bifida Benefits
FORMS: 21-0304
OMB NO: 2900-0576 EXPIRATION DATE: 08/31/2005
RESPS:4,700 HOURS:235 COSTS(000):$0
Affirmation of Enrollment Agreement
FORMS: 22-1999C
OMB NO: 2900-0577 EXPIRATION DATE: 03/31/2004
RESPS:2,000 HOURS:500 COSTS(000):$0
Spina Bifida Award Attachment Important Information
FORMS: 21-0307
OMB NO: 2900-0578 EXPIRATION DATE: 07/31/2004
RESPS:3,400 HOURS:3,400 COSTS(000):$0
Provision of Health Care to Vietnam Veterans' Children with
Spina Bifida-Regulation
FORMS: 10-7959E
OMB NO: 2900-0579 EXPIRATION DATE: 11/30/2005
RESPS:60 HOURS:15 COSTS(000):$0
Request for Vocational Training Benefits--Certain Children of
Vietnam Veterans (Title 38 CFR 21.8014)
FORMS: NONE
OMB NO: 2900-0580 EXPIRATION DATE: 11/30/2005
RESPS:650 HOURS:63 COSTS(000):$0
Request for Transportation Expense Reimbursement (Title 38 CFR
21.8370)
FORMS: NONE
OMB NO: 2900-0583 EXPIRATION DATE: 11/30/2004
RESPS:240,000 HOURS:60,000 COSTS(000):$0
Regulation for Informed Consent for Patient Care (Title 38 CFR
17.32)
FORMS: NONE
OMB NO: 2900-0585 EXPIRATION DATE: 08/31/2004
RESPS:10,000 HOURS:833 COSTS(000):$0
VA Acquisition Regulation Clause 852.211-77, Brand Name or Equal
(was 852.210-77)
FORMS: NONE
OMB NO: 2900-0586 EXPIRATION DATE: 08/31/2004
RESPS:100 HOURS:50 COSTS(000):$0
VA Acquisition Regulation Provision 852.211-75, Technical
Industry Standards
FORMS: NONE
OMB NO: 2900-0587 EXPIRATION DATE: 08/31/2004
RESPS:15,000 HOURS:2,500 COSTS(000):$0
VA Acquisition Regulation Clause 852.211-70, Service Data Manual
(previously 852.210-70)
FORMS: NONE
OMB NO: 2900-0588 EXPIRATION DATE: 08/31/2004
RESPS:30 HOURS:150 COSTS(000):$0
VA Acquisition Regulation Provision 852.211-74, Special Notice
(previously 852.210-74)
FORMS: NONE
OMB NO: 2900-0589 EXPIRATION DATE: 08/31/2004
RESPS:1,000 HOURS:17 COSTS(000):$0
VA Acquisition Regulation Provision 852.270-3, Shellfish
FORMS: NONE
OMB NO: 2900-0590 EXPIRATION DATE: 03/31/2005
RESPS:2,600 HOURS:1,300 COSTS(000):$0
VAAR Clauses 852.237-7, 852.237-71, and 852.207-70
FORMS: NONE
OMB NO: 2900-0593 EXPIRATION DATE: 08/31/2004
RESPS:346,000 HOURS:960 COSTS(000):$0
VA Acquisition Regulation Provision 852.214-70, Caution to
Bidders - Bid Envelopes
FORMS: NONE
OMB NO: 2900-0594 EXPIRATION DATE: 08/31/2005
RESPS:36 HOURS:12 COSTS(000):$0
Election to Apply Selected Reserve Service to Either Montgomery
GI Bill - Active Duty or to the Montgomery GI Bill - Selected
Reserve -- 38 CFR 21.7042 and 21.7540
FORMS: NONE
OMB NO: 2900-0600 EXPIRATION DATE: 06/30/2004
RESPS:101,652 HOURS:50,826 COSTS(000):$0
Regulation for Reconsideration of Denied claims
FORMS: NONE
OMB NO: 2900-0601 EXPIRATION DATE: 04/30/2005
RESPS:170 HOURS:85 COSTS(000):$0
Loan Guaranty: Requirements for Interest Rate Reduction
Refinancing Loans
FORMS: NONE
OMB NO: 2900-0605 EXPIRATION DATE: 04/30/2005
RESPS:20 HOURS:15 COSTS(000):$0
Application for Accreditation as a Claims Agent
FORMS: 21A
OMB NO: 2900-0606 EXPIRATION DATE: 05/31/2005
RESPS:400 HOURS:800 COSTS(000):$0
Regulation for Submission of Evidence - Title 38 CFR 17.1C1(a)(2)
FORMS: NONE
OMB NO: 2900-0609 EXPIRATION DATE: 02/28/2006
RESPS:57,500 HOURS:11,042 COSTS(000):$0
Survey of Veteran Enrollees' Health and Reliance Upon VA
FORMS: 10-21034G 10-21034H
OMB NO: 2900-0610 EXPIRATION DATE: 03/31/2006
RESPS:10 HOURS:3 COSTS(000):$0
Ecclesiastical Endorsing Organization
Verification/Reverification Information
FORMS: 10-0379
OMB NO: 2900-0613 EXPIRATION DATE: 12/31/2005
RESPS:2,400 HOURS:800 COSTS(000):$0
Recordkeeping at Flight Schools
FORMS: NONE
OMB NO: 2900-0616 EXPIRATION DATE: 04/30/2004
RESPS:1,500 HOURS:250 COSTS(000):$0
Application for Furnishing Nursing Home Care to Beneficiaries of
Veterans Affairs
FORMS: 10-1170 10-2407
OMB NO: 2900-0618 EXPIRATION DATE: 08/31/2005
RESPS:200 HOURS:40 COSTS(000):$0
Application by Insured terminally Ill Person Accelerated
Benefit- 38 CFR 9.14(e)
FORMS: NONE
OMB NO: 2900-0619 EXPIRATION DATE: 09/30/2004
RESPS:1,392,000 HOURS:23,200 COSTS(000):$0
Inquiry Routing and Information System (IRIS)
FORMS: NONE
OMB NO: 2900-0620 EXPIRATION DATE: 10/31/2005
RESPS:241,457 HOURS:120,729 COSTS(000):$0
Payment or Reimbursement for Emergency Services for
Nonservice-Connected Conditions in Non-VA Facilities
FORMS: NONE
OMB NO: 2900-0621 EXPIRATION DATE: 04/30/2005
RESPS:350 HOURS:1,750 COSTS(000):$0
National Practitioner Data Bank Regulations
FORMS: NONE
OMB NO: 2900-0622 EXPIRATION DATE: 05/31/2005
RESPS:40 HOURS:20 COSTS(000):$0
VAAR Clause 852.236-89, Buy American Act
FORMS: NONE
OMB NO: 2900-0623 EXPIRATION DATE: 05/31/2005
RESPS:870 HOURS:445 COSTS(000):$0
VAAR Clause 852.236-91, Special Notes
FORMS: NONE
OMB NO: 2900-0624 EXPIRATION DATE: 11/30/2004
RESPS:372,209 HOURS:31,017 COSTS(000):$0
Obligation to Report Factors Affecting Entitlement-38CFR
3.204(a)1)/3.256(a)(1)/3.277(b)
FORMS: NONE
OMB NO: 2900-0629 EXPIRATION DATE: 05/31/2005
RESPS:8,600 HOURS:12,900 COSTS(000):$0
Application for Extended Care Services
FORMS: 10-10EC
OMB NO: 2900-0630 EXPIRATION DATE: 02/28/2006
RESPS:500,000 HOURS:83,333 COSTS(000):$0
Regulation on Application for Fisher Houses and Other Temporary
Lodging
FORMS: NONE
OMB NO: 2900-0631 EXPIRATION DATE: 09/30/2005
RESPS:500 HOURS:500 COSTS(000):$0
Credentialing Documentation
FORMS: 10-0376A 10-0376B
OMB NO: 2900-0633 EXPIRATION DATE: 10/31/2005
RESPS:3,828 HOURS:2,871 COSTS(000):$0
Survey of Department of Veterans Affairs (VA) Pension and
Parents DIC Participants
FORMS: NONE
OMB NO: 2900-0634 EXPIRATION DATE: 10/31/2005
RESPS:5,000 HOURS:83 COSTS(000):$0
VA Museum Fund Donations Via Credit Card
FORMS: 5579A
OMB NO: 2900-0635 EXPIRATION DATE: 10/31/2005
RESPS:1,200 HOURS:200 COSTS(000):$0
Suspension of Monthly Check
FORMS: 29-0759
OMB NO: 2900-0636 EXPIRATION DATE: 10/31/2003
RESPS:51,949 HOURS:2,597 COSTS(000):$0
Request for Accelerated Payment
FORMS: NONE
OMB NO: 2900-0637 EXPIRATION DATE: 11/30/2005
RESPS:7,933 HOURS:4,628 COSTS(000):$0
Longitudinal Health Study of Persian Gulf War Veterans
FORMS: 10-21055(NR)
OMB NO: 2900-0638 EXPIRATION DATE: 06/30/2003
RESPS:3,158 HOURS:525 COSTS(000):$0
Questionnaire for Coroners and Medical Examiners
FORMS: 21-0766
OMB NO: 2900-0641 EXPIRATION DATE: 02/29/2004
RESPS:3,500 HOURS:2,625 COSTS(000):$0
Study of Health and Communications of Veterans for the
War-Related Illness and Post-Deployment Health Issues Centers
(WRIISC)
FORMS: 10-21060(NR)
OMB NO: 2900-0642 EXPIRATION DATE: 09/30/2003
RESPS:24,000 HOURS:12,000 COSTS(000):$0
VA Copayment Refund - USAA/Hartford Claim Form
FORMS: 10-0406
OMB NO: 2900-0643 EXPIRATION DATE: 09/30/2004
RESPS:2,050 HOURS:683 COSTS(000):$0
Women Veterans Ambulatory Care Use: Patterns, Barriers, and
Influences
FORMS: 10-21063(NR)
AGENCY TOTALS:
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
232 26,448,203 7,172,955 $30
Environmental Protection Agency
Regional Office San Francisco
OMB NO: 2009-0001 EXPIRATION DATE: 08/31/2004
RESPS:145 HOURS:290 COSTS(000):$0
2001 Emergency Planning and Community Right-to-know Act (EPCRA)
and Risk Management Program (RMP) Implementation Status
Questionnaire for Tribal Emergency Response Commission ...
FORMS: 2004.01
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
1 145 290 $0
Policy Planning and Evaluation
OMB NO: 2010-0026 EXPIRATION DATE: 08/31/2005
RESPS:480 HOURS:72,299 COSTS(000):$24
Regulatory Reinvention Pilot Projects Under Project XL1
FORMS: 1755.06
OMB NO: 2010-0031 EXPIRATION DATE: 10/31/2004
RESPS:2,800 HOURS:3,775 COSTS(000):$49,683
Valuing Inland Water Quality Improvements
FORMS: 1914.01
OMB NO: 2010-0032 EXPIRATION DATE: 06/30/2003
RESPS:200 HOURS:50,450 COSTS(000):$0
Performance Track Program Level One: The Environmental Achieve-
ment Track
FORMS: 1949.01
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
3 3,480 126,524 $49,707
Office of Enforcement and Compliance Assurance
OMB NO: 2020-0003 EXPIRATION DATE: 09/30/2003
RESPS:1,101 HOURS:6,432 COSTS(000):$0
Confidentiality Rules
FORMS: 1665.03
OMB NO: 2020-0007 EXPIRATION DATE: 10/31/2004
RESPS:5 HOURS:562 COSTS(000):$0
Environmental Impact Assessment of Nongovernmental Activities in
FORMS: 1808.03
OMB NO: 2020-0015 EXPIRATION DATE: 02/28/2005
RESPS:25,676 HOURS:3,956 COSTS(000):$0
Assessment of Compliance Assistance Projects
FORMS: 1860.02
OMB NO: 2020-0020 EXPIRATION DATE: 09/30/2004
RESPS:54 HOURS:4,300 COSTS(000):$0
Safe Drinking Water Act: Annual Public Water Systems Compliance
Report
FORMS: 1812.02
OMB NO: 2020-0022 EXPIRATION DATE: 08/31/2004
RESPS:700 HOURS:1,900 COSTS(000):$0
Compliance Assistance Surveys for the Marina, Metal Finishing,
Construction Site, and Auto Salvage Yard Sectors
FORMS: 2021.01
OMB NO: 2020-0023 EXPIRATION DATE: 10/31/2004
RESPS:289 HOURS:2,000 COSTS(000):$0
Proposed Information Collection Request for the Evaluation of
Print STEP.
FORMS: 1941.02
OMB NO: 2020-0027 EXPIRATION DATE: 05/31/2003
RESPS:1 HOURS:266 COSTS(000):$0
Survey of Air Quality Issues After September 11, 2001
FORMS: ICR-2094.01
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
7 27,826 19,416 $0
Administration and Resources Management
OMB NO: 2030-0005 EXPIRATION DATE: 03/31/2006
RESPS:3,888 HOURS:140,940 COSTS(000):$39
Monthly Progress Reports
FORMS: 1039.10
OMB NO: 2030-0006 EXPIRATION DATE: 02/29/2004
RESPS:1,261 HOURS:246,527 COSTS(000):$0
Invitation for Bids and Request for Proposals (IFBs and RFPs)
FORMS: 1038.10
OMB NO: 2030-0007 EXPIRATION DATE: 04/30/2003
RESPS:37,492 HOURS:9,373 COSTS(000):$0
Oral and Written Purchase Orders
FORMS: 1900-8 1900-13 1037.06
OMB NO: 2030-0016 EXPIRATION DATE: 03/31/2006
RESPS:247 HOURS:163 COSTS(000):$2
Contractor Cumulative Claim and Reconciliation
FORMS: 0246.08 1900-10
OMB NO: 2030-0020 EXPIRATION DATE: 12/31/2005
RESPS:5,100 HOURS:166,037 COSTS(000):$0
General Administrative Requirements for Assistance Programs
FORMS: 0938.09
OMB NO: 2030-0023 EXPIRATION DATE: 02/29/2004
RESPS:165 HOURS:324,885 COSTS(000):$0
Conflict of Interest, Rule #1
FORMS: 1550.05
OMB NO: 2030-0039 EXPIRATION DATE: 12/31/2005
RESPS:9,746 HOURS:28,316 COSTS(000):$0
Synopses of Proposed Contract Actions and Market Research
Activity
FORMS: 1910.02
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
7 57,899 916,241 $41
Water
OMB NO: 2040-0004 EXPIRATION DATE: 02/28/2005
RESPS:598,016 HOURS:14,221,957 COSTS(000):$0
NPDES and Sewage Sludge Monitoring Reports
FORMS: 0229.15
OMB NO: 2040-0009 EXPIRATION DATE: 09/30/2003
RESPS:2,028,826 HOURS:2,847,167 COSTS(000):$0
Information Collection Request for the National Pretreatment
Program
FORMS: 0002.09
OMB NO: 2040-0027 EXPIRATION DATE: 04/30/2003
RESPS:280 HOURS:76,752 COSTS(000):$0
Construction Grants Program Information Collection Request
FORMS: 0827.05
OMB NO: 2040-0042 EXPIRATION DATE: 01/31/2005
RESPS:422,287 HOURS:1,091,945 COSTS(000):$31,828
Underground Injection Control Program
FORMS: 0370.18 7520-1-TO-4 7520-6-TO-12 7520-14 7520-16
OMB NO: 2040-0049 EXPIRATION DATE: 08/31/2005
RESPS:298 HOURS:238,776 COSTS(000):$0
Water Quality Standards Regulation (40 CFR Part 131)
FORMS: 0988.08
OMB NO: 2040-0050 EXPIRATION DATE: 07/31/2005
RESPS:4,950 HOURS:7,672 COSTS(000):$0
Clean Watersheds Needs Survey (CWNS)
FORMS: 0318.09
OMB NO: 2040-0057 EXPIRATION DATE: 04/30/2003
RESPS:23,086 HOURS:1,140,794 COSTS(000):$0
Pollutant Discharge Elimination System and Sewage Sludge
Management State Programs
FORMS: 0168.07
OMB NO: 2040-0068 EXPIRATION DATE: 04/30/2003
RESPS:15,594 HOURS:293,323 COSTS(000):$0
National Pollutant Discharge Elimination System (NPDES)
Modification and Variance Requests
FORMS: 0029.07
OMB NO: 2040-0071 EXPIRATION DATE: 07/31/2003
RESPS:59 HOURS:4,489,147 COSTS(000):$0
National Water Quality Inventory Reports (TMDL Final Rule: Clean
Water Act Sections 305(b), 303(d), 314(a) and 106(e)).
FORMS: 1560.06
OMB NO: 2040-0086 EXPIRATION DATE: 04/30/2003
RESPS:88,209 HOURS:2,038,694 COSTS(000):$1,005
Applications for NPDES Discharge Permits and the Sewage
Management Permits
FORMS: 0226.15
OMB NO: 2040-0088 EXPIRATION DATE: 09/30/2005
RESPS:117 HOURS:65,057 COSTS(000):$0
Modification of Secondary Treatment Requirements for Discharges
into Marine Waters
FORMS: 0138.07
OMB NO: 2040-0090 EXPIRATION DATE: 11/30/2004
RESPS:494,815 HOURS:2,621,848 COSTS(000):$18,283
Public Water Systems Supervision Program: Public Notification
Amendment
FORMS: 0270.41
OMB NO: 2040-0095 EXPIRATION DATE: 04/30/2003
RESPS:111 HOURS:6,016 COSTS(000):$0
Construction Grants Delegation to States
FORMS: 0909.06
OMB NO: 2040-0101 EXPIRATION DATE: 02/29/2004
RESPS:200 HOURS:2,800 COSTS(000):$0
Questionnaire for Nominees for the Annual National Clean Water
Excellence Awards Program).
FORMS: 1287.06
OMB NO: 2040-0110 EXPIRATION DATE: 02/29/2004
RESPS:1,026,264 HOURS:1,375,412 COSTS(000):$0
Information Collection Request for the National Pollutant
Discharge Elimination System (NPDES) Compliance Assessment/
Certification Information
FORMS: ICR-1427.06
OMB NO: 2040-0118 EXPIRATION DATE: 11/30/2004
RESPS:2,244 HOURS:262,905 COSTS(000):$0
CWA State Revolving Fund Program
FORMS: 1391.06
OMB NO: 2040-0138 EXPIRATION DATE: 04/30/2003
RESPS:41 HOURS:46,767 COSTS(000):$0
National Estuary Program
FORMS: 1500.04
OMB NO: 2040-0153 EXPIRATION DATE: 04/30/2003
RESPS:29 HOURS:3,625 COSTS(000):$0
Approval of State Coastal Nonpoint Control Program -- CZARA
Section 6217
FORMS: EPA-1569.04
OMB NO: 2040-0164 EXPIRATION DATE: 04/30/2003
RESPS:895 HOURS:2,556 COSTS(000):$0
Reporting Requirements under EPA's Water Alliances for Voluntary
Efficiency (WAVE) Program
FORMS: 1654.03
OMB NO: 2040-0168 EXPIRATION DATE: 04/30/2003
RESPS:20,005 HOURS:100,667 COSTS(000):$0
Clean Water Act Section 404 State-Assumed Programs
FORMS: 0220.08
OMB NO: 2040-0170 EXPIRATION DATE: 10/31/2004
RESPS:2.483 HOURS:580,044 COSTS(000):$182
Information Collection Request for the Combined Sewer Overflow
Policy
FORMS: 1680.03
OMB NO: 2040-0180 EXPIRATION DATE: 11/30/2004
RESPS:1,257 HOURS:122,863 COSTS(000):$0
National Pollutant Discharge Elimination System Great Lakes
Water Quality Guidance
FORMS: 1639.04
OMB NO: 2040-0185 EXPIRATION DATE: 06/30/2003
RESPS:1,377 HOURS:192,950 COSTS(000):$0
Information Collection Request for Drinking Water State
Revolving Fund Programs
FORMS: 1803.03
OMB NO: 2040-0187 EXPIRATION DATE: 10/31/2004
RESPS:15 HOURS:2,207 COSTS(000):$2
Establishing No-Discharge Zones (NDZs) Under Clean Water Act
Section 312
FORMS: 1791.03
OMB NO: 2040-0188 EXPIRATION DATE: 04/30/2003
RESPS:186,121 HOURS:4,753,452 COSTS(000):$2,045
Notice of Intent for Storm Water Discharges Associated with
Construction Activity under a NPDES General Permit
FORMS: 3510-9 1842.02
OMB NO: 2040-0189 EXPIRATION DATE: 04/30/2003
RESPS:533 HOURS:1,280 COSTS(000):$1
National Health Protection Survey of Beaches
FORMS: 1814.02
OMB NO: 2040-0197 EXPIRATION DATE: 10/31/2004
RESPS:104 HOURS:2,608,787 COSTS(000):$7,102
State Source Water Assessment and Protection Programs
FORMS: 1816.02
OMB NO: 2040-0202 EXPIRATION DATE: 06/30/2005
RESPS:29 HOURS:1,418 COSTS(000):$0
Milestones Plan for the Bleached papergrade Kraft and Soda Sub-
category of the Pulp, Paper, and Paperboard Point Source Category
FORMS: 1877.02
OMB NO: 2040-0204 EXPIRATION DATE: 12/31/2004
RESPS:2,676,159 HOURS:4,337,535 COSTS(000):$148,459
Disinfectants/Disinfection Byproducts, Chemical, and Radionu-
clides Information Collection Request; Unregulated Contaminant
Monitoring Regulation List 2 Amendments (proposed rule)
FORMS: 1896.03
OMB NO: 2040-0205 EXPIRATION DATE: 11/30/2004
RESPS:22,602,222 HOURS:8,193,200 COSTS(000):$82,564
Microbial Rules
FORMS: 1895.02
OMB NO: 2040-0207 EXPIRATION DATE: 06/30/2005
RESPS:130 HOURS:60,909 COSTS(000):$0
Best Management Practices (BMP) for Bleached Papergrade Kraft
and Soda Subcategory and the Papergrade Kraft Sulfite
Subcategory of the Pulp, Paper and Paperboard Point Source
Category
FORMS: 1829.02
OMB NO: 2040-0208 EXPIRATION DATE: 12/31/2003
RESPS:170 HOURS:11,519 COSTS(000):$3,407
Unregulated Contiminant Monitoring Regulations for Public Water
systems; Analytical Methods for List 2 Contaminants (Proposed
Rule)
FORMS: 1882.02
OMB NO: 2040-0210 EXPIRATION DATE: 06/30/2003
RESPS:159,929 HOURS:2,431,728 COSTS(000):$14,026
Information Collection Request: National Primary Drinking Water
Regulation for Lead and Copper (Final Rule)
FORMS: 1912.01
OMB NO: 2040-0211 EXPIRATION DATE: 04/30/2003
RESPS:36,421 HOURS:56,369 COSTS(000):$0
Phase II of the NPDES Storm Water Program (Final Rule ICR)
FORMS: 1820.02
OMB NO: 2040-0213 EXPIRATION DATE: 04/30/2003
RESPS:1,836 HOURS:128,736 COSTS(000):$14
Industry Detailed Questionnaire: Phase II Cooling Water Intake
Structures
FORMS: 1838.01
OMB NO: 2040-0216 EXPIRATION DATE: 09/30/2003
RESPS:20 HOURS:3,603 COSTS(000):$0
Information Collection Request for the State Water Quality Pro-
gram management Gap Analysis.
FORMS: 1945.01
OMB NO: 2040-0224 EXPIRATION DATE: 08/31/2004
RESPS:7,942 HOURS:66,363 COSTS(000):$0
Information Collection Request for Filter Backwash Recycling
Rule (Final Rule)
FORMS: 1928.02
OMB NO: 2040-0225 EXPIRATION DATE: 02/29/2004
RESPS:2,000 HOURS:20,060 COSTS(000):$3
Meat Products Industry Survey
FORMS: 1961.01
OMB NO: 2040-0226 EXPIRATION DATE: 01/31/2004
RESPS:92 HOURS:3,565 COSTS(000):$1
Information Collection Request for the National Listing of
Advisories
FORMS: 1959.01
OMB NO: 2040-0227 EXPIRATION DATE: 02/29/2004
RESPS:1,442 HOURS:3,381 COSTS(000):$0
Community Water System Survey
FORMS: 1946.01
OMB NO: 2040-0228 EXPIRATION DATE: 11/30/2003
RESPS:33 HOURS:342,873 COSTS(000):$0
Information Collection Request for National Primary Drinking
Water Regulations: Radionuclides
FORMS: 1972.01
OMB NO: 2040-0229 EXPIRATION DATE: 10/31/2004
RESPS:15,131 HOURS:330,329 COSTS(000):$6,653
Information Collection Request for Long Term 1 Enhanced Surface
Water Treatment Rule (Final Rule)
FORMS: 1928.03
OMB NO: 2040-0230 EXPIRATION DATE: 01/31/2004
RESPS:67 HOURS:47,168 COSTS(000):$0
Information Collection Request for Best Management Practices
Alternatives, Effluent Limitations Guidelines and Standards, Oil
and Gas Extraction Point Source Category (40 CFR Part 435)
FORMS: 1953.02
OMB NO: 2040-0231 EXPIRATION DATE: 01/31/2004
RESPS:49,813 HOURS:667,179 COSTS(000):$0
National Primary Drinking Water Regulations: Arsenic and
Clarifications to Compliance and New Source Contaminants
Monitoring
FORMS: EPA-ICR-1948.02
OMB NO: 2040-0235 EXPIRATION DATE: 10/31/2004
RESPS:79 HOURS:19,144 COSTS(000):$0
Pollution Prevention Compliance Alternative; Transportation
Equipment Cleaning (TEC) Point Source Category (40 CFR Part 442)
FORMS: 2018.01
OMB NO: 2040-0236 EXPIRATION DATE: 06/30/2005
RESPS:22,799 HOURS:100,808 COSTS(000):$914
Operator Certification Guidelines and Operator Certification
Expense Reimbursement Grants Program
FORMS: 1955.02
OMB NO: 2040-0237 EXPIRATION DATE: 08/31/2004
RESPS:6,000 HOURS:6,000 COSTS(000):$16
200 Aquatic Animal Production Industry Surveys
FORMS: 1988.01
OMB NO: 2040-0238 EXPIRATION DATE: 09/30/2004
RESPS:144 HOURS:336 COSTS(000):$0
National Wastewater Operator Training and Technical Assistance
Program - CWA 104(g)(1)
FORMS: 1977.01
OMB NO: 2040-0239 EXPIRATION DATE: 11/30/2004
RESPS:93 HOURS:9,261 COSTS(000):$0
Information Collection Request for Baseline Standards and Best
Management Practices for the Coal Mining Point Source Category
(40 CFR Part 434) - Coal Remining Subcategory and Western Alkalin
FORMS: 1944.02
OMB NO: 2040-0240 EXPIRATION DATE: 11/30/2004
RESPS:825 HOURS:19,840 COSTS(000):$12
2000 Aquatic Animal Production Industry Surveys
FORMS: 2038.01
OMB NO: 2040-0241 EXPIRATION DATE: 11/30/2004
RESPS:152 HOURS:40,376 COSTS(000):$1,766
Cooling Water Intake Structures New Facility Final Rule
FORMS: 1973.02
OMB NO: 2040-0242 EXPIRATION DATE: 02/28/2005
RESPS:86 HOURS:480 COSTS(000):$0
Certification in Lieu of Chloroform Minimum Monitoring Require-
ments for Direct and Indirect Discharging Mills in the Bleached
Papergrade Kraft and Soda Subcategory of the Public, Paper,...
FORMS: 2015.01
OMB NO: 2040-0243 EXPIRATION DATE: 02/28/2005
RESPS:104 HOURS:36,858 COSTS(000):$19,002
Minimum Monitoring Requirements for Direct and Indirect
Discharg- ing Mills in the Bleached Papergrade Kraft and Soda
Subcategory and the Papergrade Sulfite Subcategory of the Pulp,
Paper, ...
FORMS: 1878.01
OMB NO: 2040-0244 EXPIRATION DATE: 07/31/2005
RESPS:35 HOURS:69,755 COSTS(000):$473
US EPA BEACH Act Grant Program
FORMS: 2048.01
OMB NO: 2040-0246 EXPIRATION DATE: 10/31/2005
RESPS:60 HOURS:4,347 COSTS(000):$123
Laboratory Quality Assurance Evaluation Program for Analysis of
Cryptosporidium Under the Safe Drinking Water Act
FORMS: 2067.02
OMB NO: 2040-0247 EXPIRATION DATE: 05/31/2003
RESPS:1,250 HOURS:188 COSTS(000):$0
Drinking Water Customer Satisfaction Survey
FORMS: 2016.01
OMB NO: 2040-0248 EXPIRATION DATE: 07/31/2003
RESPS:535 HOURS:6,300 COSTS(000):$0
2003 Report to Congress on Impacvts and Control of Combined
Sewer Overflows and Sanitary Sewer Overflows
FORMS: 2063.01
OMB NO: 2040-0251 EXPIRATION DATE: 11/30/2005
RESPS:3,790 HOURS:14,809 COSTS(000):$0
2003 Drinking Water Infrausructure Needs Survey
FORMS: 2085.01
OMB NO: 2040-0253 EXPIRATION DATE: 09/30/2003
RESPS:22,499 HOURS:2,652,392 COSTS(000):$82
Title VI of the Public Health Security and Bioterrorism Pre-
paredness and Response Act of 2002: Drinking Water Security and
Safety
FORMS: 2103.01
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
59 30,527,622 58,882,292 $337,963
Solid Waste and Emergency Response
OMB NO: 2050-0009 EXPIRATION DATE: 04/30/2003
RESPS:579 HOURS:177,732 COSTS(000):$48,468
Part B Permit Application, Permit Modifications, and Special
Permits (Corrective Action Management Proposed Rule)
FORMS: 1573.08
OMB NO: 2050-0021 EXPIRATION DATE: 08/31/2005
RESPS:419,033 HOURS:2,208,701 COSTS(000):$22,541
Spill Prevention, Control and Countermeasures (SPCC) Plans
FORMS: 0328.10
OMB NO: 2050-0024 EXPIRATION DATE: 06/30/2003
RESPS:505,047 HOURS:188,624 COSTS(000):$26
The 2001 Hazardous Waste Report (Biennial Report)
FORMS: 0976.10
OMB NO: 2050-0028 EXPIRATION DATE: 01/31/2006
RESPS:31,125 HOURS:96,250 COSTS(000):$131
Notification of Regulated Waste Activity
FORMS: 0261.14 8700-12
OMB NO: 2050-0033 EXPIRATION DATE: 01/31/2005
RESPS:824 HOURS:96,913 COSTS(000):$16,757
Facility Ground-water Monitoring Requirments
FORMS: 0959.11
OMB NO: 2050-0034 EXPIRATION DATE: 11/30/2005
RESPS:36 HOURS:576 COSTS(000):$1
RCRA Hazardous Waste Permit Application and Modification, Part A
FORMS: 0262.10
OMB NO: 2050-0035 EXPIRATION DATE: 10/31/2004
RESPS:140,877 HOURS:475,802 COSTS(000):$54
Hazardous Waste Generator Standards
FORMS: 0820.08
OMB NO: 2050-0039 EXPIRATION DATE: 05/31/2005
RESPS:2.20 HOURS:3,612,539 COSTS(000):$2,416
Requirements for Generators, Transporters, and Disposers under
the RCRA Hazardous Waste Manifest System
FORMS: 0801.14
OMB NO: 2050-0041 EXPIRATION DATE: 07/31/2005
RESPS:50 HOURS:19,968 COSTS(000):$0
Final Authorization for Hazardous Waste Management
FORMS: 0969.06
OMB NO: 2050-0046 EXPIRATION DATE: 04/30/2004
RESPS:23,726 HOURS:97,277 COSTS(000):$0
Notification of Episodic Releases of Oil and Hazardous Sub-
stances (Renewal)
FORMS: 1049.09
OMB NO: 2050-0050 EXPIRATION DATE: 12/31/2003
RESPS:6,341 HOURS:287,069 COSTS(000):$875
Hazardous Waste Specific Unit Requirements, and Special Waste
processes and Types
FORMS: 1572.05
OMB NO: 2050-0053 EXPIRATION DATE: 11/30/2004
RESPS:166 HOURS:20,809 COSTS(000):$888
Identification Listing and Rulemaking Petitions (Zinc Ferti-
lizers Final Rule)
FORMS: 1189.11
OMB NO: 2050-0062 EXPIRATION DATE: 09/30/2003
RESPS:0.33 HOURS:3,137 COSTS(000):$1
Land Disposal Restrictions No-Migration Variances
FORMS: 1353.06
OMB NO: 2050-0068 EXPIRATION DATE: 10/31/2004
RESPS:500,000 HOURS:6,025,543 COSTS(000):$363
Underground Storage Tanks: Technical & Financial Require- ments
& State Program Approval Procedures
FORMS: 1360.06
OMB NO: 2050-0072 EXPIRATION DATE: 10/31/2004
RESPS:504,000 HOURS:2,028,701 COSTS(000):$6,391
Community Right-to-Know Reporting Requirements under section 311
and 312 of the Emergency Planning and Community Right-to- Know
Act (EPCRA) - Minimal Hazard Proposed Rule
FORMS: 1352.09
OMB NO: 2050-0073 EXPIRATION DATE: 12/31/2005
RESPS:1,969 HOURS:307,949 COSTS(000):$26,353
Information Requirements for Boilers and Industrial Furnaces:
General Hazardous Waste Facility Standards, Specific Unit
Require ments, & Part B Permit Applicaition and Modification
Requirements
FORMS: 1361.09
OMB NO: 2050-0077 EXPIRATION DATE: 08/31/2004
RESPS:200 HOURS:1,800 COSTS(000):$0
Application for Reimbursement to Local Governments for Emergency
Response to Hazardous Substance Releases Under CERCLA section 123
FORMS: 1425.05 9310-1
OMB NO: 2050-0078 EXPIRATION DATE: 09/30/2003
RESPS:315 HOURS:3,121 COSTS(000):$0
Trade Secret Claims for Emergency Planning and Community
Right-to-Know (EPCRA Section 322)
FORMS: ICR-1428.05
OMB NO: 2050-0085 EXPIRATION DATE: 02/29/2004
RESPS:274,033 HOURS:1,182,612 COSTS(000):$72,851
Lland Disposal Restrictions
FORMS: 1442.17
OMB NO: 2050-0086 EXPIRATION DATE: 11/30/2004
RESPS:23,280 HOURS:249,451 COSTS(000):$76
Continuous Release Reporting Regulations (CRRR) under the
Comprehensive Environmental Response, Compensation, and
Liability Act of 1980 (CERCLA)
FORMS: 1445.05
OMB NO: 2050-0092 EXPIRATION DATE: 02/28/2006
RESPS:82,260 HOURS:212,460 COSTS(000):$15
Emergency Planning and Release Notification Requirements under
Emergency Planning and Community Right-to-Know Act Sections 302,
303 and 304.
FORMS: 1395.05
OMB NO: 2050-0095 EXPIRATION DATE: 11/30/2004
RESPS:60 HOURS:230,533 COSTS(000):$0
Superfund Site Evaluation and Hazard Ranking System
FORMS: 1488.05
OMB NO: 2050-0096 EXPIRATION DATE: 10/31/2004
RESPS:7,560 HOURS:185,860 COSTS(000):$0
National Oil and Hazardous Substances Pollution Contingency Plan
(NCP); (40 CFR Part 300)
FORMS: ICR-1463.05
OMB NO: 2050-0105 EXPIRATION DATE: 12/31/2005
RESPS:24,000 HOURS:255,427 COSTS(000):$0
EPA Worker Protection Standard for Hazardous Waste Operations
and Emergency Response
FORMS: 1426.06
OMB NO: 2050-0120 EXPIRATION DATE: 02/28/2006
RESPS:1,675 HOURS:719,059 COSTS(000):$760
General Hazardous Waste Facility Standards
FORMS: 1571.07
OMB NO: 2050-0122 EXPIRATION DATE: 08/31/2003
RESPS:2,300 HOURS:239,858 COSTS(000):$0
Recordkeeping and Reporting Requirements for 40 CFR Part 258 -
Solid Waste Disposal Facilities and Practices
FORMS: 1381.06
OMB NO: 2050-0124 EXPIRATION DATE: 12/31/2005
RESPS:1,640 HOURS:460,286 COSTS(000):$10,011
Used Oil Management Standards Recordkeeping and Reporting
Requirements
FORMS: 1286.06
OMB NO: 2050-0135 EXPIRATION DATE: 05/31/2004
RESPS:10,310 HOURS:583,130 COSTS(000):$22
Oil Pollution Act Facility Response Plans - 40 CFR Part 112.20
FORMS: 1630.07
OMB NO: 2050-0139 EXPIRATION DATE: 05/31/2004
RESPS:1,740 HOURS:64,260 COSTS(000):$0
Reporting and Recordkeeping Requirements Under EPA's WasteWise
Program
FORMS: 1698.04
OMB NO: 2050-0141 EXPIRATION DATE: 01/31/2004
RESPS:28 HOURS:826 COSTS(000):$150
The National Oil and Hazardous Substances Pollution Contingency
Plan Subpart J (Product Schedule)
FORMS: 1664.04
OMB NO: 2050-0143 EXPIRATION DATE: 04/30/2004
RESPS:1,562 HOURS:9,334 COSTS(000):$1
Exports from and Imports to the United States under
International and Bilateral Waste Agreements
FORMS: 1647.03
OMB NO: 2050-0144 EXPIRATION DATE: 10/31/2005
RESPS:5,550 HOURS:97,160 COSTS(000):$6
Information Collection Requirements for Registration and
Documentation of Risk Management Plans under Section 112r of the
Clean Air Act.
FORMS: 1656.09
OMB NO: 2050-0145 EXPIRATION DATE: 11/30/2004
RESPS:133,181 HOURS:218,168 COSTS(000):$3
Reporting and Recording Requirements for the Universal Waste
Handlers and Destination Facilities
FORMS: 1597.04
OMB NO: 2050-0149 EXPIRATION DATE: 08/31/2005
RESPS:33 HOURS:3,005 COSTS(000):$4
RCRA Expanded Public Participation
FORMS: 1688.04
OMB NO: 2050-0152 EXPIRATION DATE: 06/30/2005
RESPS:6 HOURS:3,189 COSTS(000):$0
State Program Adequacy Determination: Municipal Solid Waste
Landfills (MSWLFs) and Non-municipal, Non-hazardous Waste
Disposal Units that Receive Conditionally Exempt Small
FORMS: 1608.03
OMB NO: 2050-0154 EXPIRATION DATE: 11/30/2005
RESPS:145 HOURS:9,675 COSTS(000):$938
Criteria for Clssification of Solid Waste Disposal Facilities
and Practices -- 40 CFR Part 257 Subpart B.
FORMS: 1745.04
OMB NO: 2050-0161 EXPIRATION DATE: 09/30/2005
RESPS:176 HOURS:4,959 COSTS(000):$35
Hazardous Remediation Waste Management Requirements (HWIR-Media)
FORMS: 1775.03
OMB NO: 2050-0171 EXPIRATION DATE: 10/31/2004
RESPS:930 HOURS:71,075 COSTS(000):$1,612
Amendments to the Reporting and Recordkeeping Requirements for
National Emissions Standards for Hazardous Air Pollutants
(NESHAP) for Hazardous Waste Combustors - Direct Final Rule.
FORMS: 1773.05
OMB NO: 2050-0172 EXPIRATION DATE: 10/31/2003
RESPS:10,380 HOURS:99,518 COSTS(000):$126
Distribution of Off-site Consequence Analysis Information under
Section 112(r) of the Clean Air Act.
FORMS: 1981.01
OMB NO: 2050-0173 EXPIRATION DATE: 01/31/2004
RESPS:5 HOURS:93 COSTS(000):$1
Hazardous Waste Listing for Chlorinated Aliphatics Production
Wastes
FORMS: 1924.02
OMB NO: 2050-0175 EXPIRATION DATE: 12/31/2003
RESPS:10,157 HOURS:2,590 COSTS(000):$143
The RCRA Subtitle C Site Identification Form
FORMS: 2005.01 8700-13A/B
OMB NO: 2050-0179 EXPIRATION DATE: 11/30/2004
RESPS:581 HOURS:5,115 COSTS(000):$0
Cooperative Agreements and Superfund State Contracts for
Superfund Response Actions
FORMS: 1487.07
OMB NO: 2050-0181 EXPIRATION DATE: 08/31/2004
RESPS:7,010 HOURS:3,079 COSTS(000):$4
Storage, Treatment, Transportation, and Disposal of Mixed Waste
(Final Rule)
FORMS: 1922.02
OMB NO: 2050-0182 EXPIRATION DATE: 12/31/2004
RESPS:175 HOURS:1 COSTS(000):$2
Standardized Permit for RCRA Hazardous Waste
FORMS: 1935.01
OMB NO: 2050-0185 EXPIRATION DATE: 05/31/2005
RESPS:262 HOURS:2,620 COSTS(000):$0
Institional Controls Tracking Systems and Costs Survey
FORMS: 2043.01
OMB NO: 2050-0187 EXPIRATION DATE: 10/31/2004
RESPS:1,034 HOURS:2,050 COSTS(000):$1
Reporting and Recordkeeping Requirements for NESHAP: Standards
for Hazardous Air Pollutants for Hazardous Waste Combustors
(Final Amendments Rule); Final Rule
FORMS: 2070.01
OMB NO: 2050-0188 EXPIRATION DATE: 05/31/2005
RESPS:200 HOURS:2,000 COSTS(000):$0
Soil Ingestion Research
FORMS: 1965.01
OMB NO: 2050-0189 EXPIRATION DATE: 03/31/2006
RESPS:550 HOURS:1,375 COSTS(000):$0
Tribal Lands Hazardous Waste Sites Census
FORMS: 2059.01
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
48 2,735,113 20,571,279 $212,026
Air and Radiation
OMB NO: 2060-0001 EXPIRATION DATE: 04/30/2003
RESPS:105 HOURS:3,092 COSTS(000):$50
NSPS for Beverage Can Surface Coating -- 40 CFR Part 60, Subpart
WW
FORMS: 0663.07
OMB NO: 2060-0002 EXPIRATION DATE: 11/30/2004
RESPS:10 HOURS:15,089 COSTS(000):$3,105
NSPS for Asphalt Processing and Asphalt Roofing Manufacture,
Subpart UU - Reporting and Recordkeeping Requirements
FORMS: 0661.06
OMB NO: 2060-0003 EXPIRATION DATE: 10/31/2004
RESPS:1,022 HOURS:4,878,634 COSTS(000):$0
Prevention of Significant Deterioration Non-Attainment Area New
Source Review (Final Rule for PSD and NSR Applicability)
FORMS: 1230.11 2074.01
OMB NO: 2060-0004 EXPIRATION DATE: 04/30/2003
RESPS:1,025 HOURS:39,104 COSTS(000):$1,880
Pressure-Sensitive Tape and Lable Surface Coating Operations,
Information Request -- NSPS Subpart RR
FORMS: 0658.07
OMB NO: 2060-0006 EXPIRATION DATE: 12/31/2005
RESPS:40 HOURS:11,420 COSTS(000):$0
NSPS Bulk Gasoline Terminals, 40 CFR60, Supbart XX
FORMS: 0664.07
OMB NO: 2060-0015 EXPIRATION DATE: 08/31/2003
RESPS:22,846 HOURS:8,363 COSTS(000):$0
Environmental Radiation Ambient Monitoring System (ERAMS)
FORMS: NONE
OMB NO: 2060-0016 EXPIRATION DATE: 09/30/2005
RESPS:44 HOURS:1,760 COSTS(000):$14
NSPS for Metallic Mineral Processing Plants (Subpart LL)
FORMS: 0982.07
OMB NO: 2060-0019 EXPIRATION DATE: 01/31/2004
RESPS:71 HOURS:1,796 COSTS(000):$3,568
New Source Performace Standards for Nitric Acid Plants, Subpart
G, Part 60
FORMS: 1056.07
OMB NO: 2060-0021 EXPIRATION DATE: 04/30/2003
RESPS:170 HOURS:9,959 COSTS(000):$2,828
New Source Performance Standard (NSPS) for Kraft Pulp Mills --
Subpart BB
FORMS: 1055.06
OMB NO: 2060-0022 EXPIRATION DATE: 11/30/2005
RESPS:430 HOURS:17,359 COSTS(000):$91
Standards of Performance for Petroleum Refineries (40 CFR Part
60 Subpart J)
FORMS: 1054.08
OMB NO: 2060-0023 EXPIRATION DATE: 04/30/2003
RESPS:494 HOURS:28,606 COSTS(000):$3,095
Standard of Performance for Electric Utility Steam Generating
Units -- NSPS Subpart Da
FORMS: 1053.06
OMB NO: 2060-0025 EXPIRATION DATE: 11/30/2004
RESPS:448 HOURS:7,968 COSTS(000):$987
New Source Performance Standard for Portland Cement Plants, 40
CFR Part 60, Subpart F
FORMS: 1051.08
OMB NO: 2060-0026 EXPIRATION DATE: 04/30/2003
RESPS:2,640 HOURS:62,865 COSTS(000):$9,900
Standards of Performance for Fossil-Fuel-Fired Steam Generating
Units -- NSPS Subpart D
FORMS: 1052.06
OMB NO: 2060-0028 EXPIRATION DATE: 07/31/2004
RESPS:1,650 HOURS:93,439 COSTS(000):$0
NSPS-Standard of Performance for Stationary Gas Turbines 40 CFR
Part 60, Subpart GG
FORMS: 1071.07
OMB NO: 2060-0029 EXPIRATION DATE: 10/31/2005
RESPS:10 HOURS:1,012 COSTS(000):$26
NSPS for Iron and Steel Plants: Basic Oxygen Process Furnaces
(40 CFR Part 60, Subparts N and Na)
FORMS: 1069.07
OMB NO: 2060-0032 EXPIRATION DATE: 01/31/2004
RESPS:2 HOURS:182 COSTS(000):$0
NSPS for Ammonium Sulfate Manufacturing Plants, 40 CFR Part 60,
Subpart PP
FORMS: 1066.03
OMB NO: 2060-0034 EXPIRATION DATE: 09/30/2003
RESPS:171 HOURS:145,599 COSTS(000):$7
NSPS Subpart MM-Automobile and Light Duty Truck Surface Coating
Opeations 40 CFR Part 63, Subpart MM
FORMS: 1064.09
OMB NO: 2060-0035 EXPIRATION DATE: 09/30/2004
RESPS:294 HOURS:9,089 COSTS(000):$5,845
NSPS for Sewage Sludge Treatment Plant Incineration (40 CFR Part
60, Subpart O)
FORMS: 1063.08
OMB NO: 2060-0037 EXPIRATION DATE: 06/30/2003
RESPS:11 HOURS:963 COSTS(000):$0
NSPS for Phosphate Fertilizer Industry, 40 CFR Part 60, Subparts
T, U, V, W, and X
FORMS: 1061.08
OMB NO: 2060-0038 EXPIRATION DATE: 06/30/2003
RESPS:182 HOURS:48,413 COSTS(000):$95
The New Source Performance Standards (NSPS) for Steel Plants:
Electric Arc Furnaces and Argon-Oxygen Decarburization Vessels.
FORMS: 1060.10 40CFR PART60 SUBPARTAA SUBPARTAAA
OMB NO: 2060-0040 EXPIRATION DATE: 10/31/2004
RESPS:96 HOURS:8,544 COSTS(000):$240
NSPS Subpart E: Standards of Performance for Incinerators (40
CFR Part 60, subpart E)
FORMS: 1058.07
OMB NO: 2060-0041 EXPIRATION DATE: 10/31/2005
RESPS:212 HOURS:23,320 COSTS(000):$477
NSPS for Sulfuric Acid Plants (40 CFR Part 60, Subpart H)
FORMS: 1057.09
OMB NO: 2060-0043 EXPIRATION DATE: 10/31/2005
RESPS:31 HOURS:4,524 COSTS(000):$98
NESHAP for Inorganic Arsenic Emissions from Glass Manufacturing
Plants (40 CFR Part 61, Subpart N)
FORMS: 1081.07
OMB NO: 2060-0048 EXPIRATION DATE: 01/31/2004
RESPS:46 HOURS:4,925 COSTS(000):$0
Emission Defect Information Reports (DIR) and Voluntary Emission
Recall Reports (VERR) for manufacturers of on-highway heavy-duty
engines, non-road compression-ignition, engines, non-road...
FORMS: 0282.12
OMB NO: 2060-0050 EXPIRATION DATE: 06/30/2003
RESPS:2,320 HOURS:31,746 COSTS(000):$0
NSPS 40 CFR, Part 60, Subpart OOO - Nonmetallic Mineral Pro-
cessing
FORMS: 1084.06
OMB NO: 2060-0054 EXPIRATION DATE: 12/31/2005
RESPS:87 HOURS:590 COSTS(000):$261
NSPS for Glass Manufacturing Plants (40 Part 60, Subpart CC)
FORMS: 1131.07
OMB NO: 2060-0059 EXPIRATION DATE: 04/30/2003
RESPS:85 HOURS:2,696 COSTS(000):$228
Synthetic Fiber Production Facilities -- NSPS Subpart HHH
FORMS: 1156.08
OMB NO: 2060-0060 EXPIRATION DATE: 02/29/2004
RESPS:2 HOURS:1,722 COSTS(000):$0
Emission Control System Performance Warranty Regulations and
Voluntary Aftermath Part Certification Program, 40 CFR Part 85,
Subpart V
FORMS: 0116.06
OMB NO: 2060-0063 EXPIRATION DATE: 04/30/2003
RESPS:102 HOURS:4,190 COSTS(000):$95
Lime Manufacturing -- NSPS Subpart HH
FORMS: 1167.06
OMB NO: 2060-0067 EXPIRATION DATE: 12/31/2005
RESPS:102 HOURS:6,137 COSTS(000):$0
NSPS Equipment Leaks of VOC in Peroleum Refineries (40 CFR Part
60, subpart GGG)
FORMS: 0983.07
OMB NO: 2060-0071 EXPIRATION DATE: 11/30/2004
RESPS:308 HOURS:16,159 COSTS(000):$1,980
NESHAP for Vinyl Chloride 40 CFR Part 61, Subpart F
FORMS: 0186.09
OMB NO: 2060-0072 EXPIRATION DATE: 04/30/2003
RESPS:3,016 HOURS:575,033 COSTS(000):$25,955
NSPS Subpart Db, Standards of Performance for Industrial-Commer-
cial-Institutional Steam Generating Units
FORMS: 1088.09
OMB NO: 2060-0073 EXPIRATION DATE: 06/30/2003
RESPS:21 HOURS:329 COSTS(000):$52
NSPS, 40 CFR Part 60, Subpart FFF for Flexible Vinyl and
Urethane Coating and Printing
FORMS: 1157.06
OMB NO: 2060-0078 EXPIRATION DATE: 06/30/2003
RESPS:3,750 HOURS:1,649 COSTS(000):$0
Mobile Source Emission Factor Recruitment Questionnaire
FORMS: 0619.08
OMB NO: 2060-0079 EXPIRATION DATE: 04/30/2003
RESPS:93 HOURS:1,483 COSTS(000):$0
Petroleum Dry Cleaners -- NSPS Subpart JJ
FORMS: 0997.06
OMB NO: 2060-0080 EXPIRATION DATE: 06/30/2003
RESPS:23 HOURS:35 COSTS(000):$0
NSPS CFR 40, Part 60, Subpart L - Secondary Lead Smelters
FORMS: 1128.06
OMB NO: 2060-0081 EXPIRATION DATE: 06/30/2003
RESPS:82 HOURS:123 COSTS(000):$18
NSPS Subpart KK - Lead-Acid Battery Manufacturing, 40 CFR Part
60 Subpart KK
FORMS: 1072.06
OMB NO: 2060-0082 EXPIRATION DATE: 04/30/2003
RESPS:121 HOURS:250 COSTS(000):$0
Information Requirements for Grain Elevators -- NSPS Subpart DD
FORMS: 1130.06
OMB NO: 2060-0083 EXPIRATION DATE: 04/30/2003
RESPS:200 HOURS:6,890 COSTS(000):$0
Hot Mix Asphalt Facilities -- NSPS Subpart I
FORMS: 1127.06
OMB NO: 2060-0084 EXPIRATION DATE: 04/30/2003
RESPS:520 HOURS:2,404,606 COSTS(000):$73,642
Ambient Air Quality Surveillance -- 40 CFR Part 58
FORMS: 0940.16
OMB NO: 2060-0086 EXPIRATION DATE: 08/31/2003
RESPS:1,800 HOURS:600 COSTS(000):$0
Investigation into Possible Noncompliance of Motor Vehicles
FORMS: 0222.6
OMB NO: 2060-0088 EXPIRATION DATE: 10/31/2004
RESPS:54 HOURS:11,448 COSTS(000):$29
Annual Updates of Emission Data to the Aerometric Information
Retrieval System (AIRS)
FORMS: 0916.11
OMB NO: 2060-0092 EXPIRATION DATE: 09/30/2004
RESPS:166 HOURS:2,232 COSTS(000):$35
NESHAP for Beryllium (40 CFR part 61, subpart C)
FORMS: 0193.07
OMB NO: 2060-0095 EXPIRATION DATE: 08/31/2003
RESPS:21,200 HOURS:14,400 COSTS(000):$1,296
Importation Requirements for Importation of Nonconforming Vehi-
cles
FORMS: 0010.09
OMB NO: 2060-0096 EXPIRATION DATE: 01/31/2005
RESPS:356 HOURS:85,496 COSTS(000):$0
Source Compliance and State Action Reporting
FORMS: 0107.07
OMB NO: 2060-0097 EXPIRATION DATE: 06/30/2003
RESPS:24 HOURS:26,504 COSTS(000):$0
National Emission Standard for Mercury -- NESHAP Part 61 Subpart
E
FORMS: 0113.07
OMB NO: 2060-0101 EXPIRATION DATE: 03/31/2006
RESPS:123,008 HOURS:342,249 COSTS(000):$0
NESHAP for Asbestos, 40 CFR Part 61, Subpart M
FORMS: 0111.10
OMB NO: 2060-0104 EXPIRATION DATE: 07/31/2005
RESPS:70 HOURS:514,000 COSTS(000):$7,100
Motor Vehicle Emission and Fuel Economy Compliance; Light Duty
Vehicles, Light Duty Trucks and Motorcycle (Consolidated/Renewal)
FORMS: 0783.42
OMB NO: 2060-0105 EXPIRATION DATE: 10/31/2004
RESPS:60 HOURS:3,871 COSTS(000):$0
New Source Performance Standards for Graphic Arts Industry, 40
CFR Part 60, Subpart QQ
FORMS: 0657.07
OMB NO: 2060-0106 EXPIRATION DATE: 04/30/2003
RESPS:1,600 HOURS:101,070 COSTS(000):$1,120
NSPS for Metal Furniture Coating -- 40 CFR Part 60, Subpart EE
FORMS: 0649.07
OMB NO: 2060-0107 EXPIRATION DATE: 12/31/2005
RESPS:404 HOURS:14,531 COSTS(000):$318
NSPS for Metal Coil Surface Coating (Subpart TT)
FORMS: 0660.08
OMB NO: 2060-0108 EXPIRATION DATE: 04/30/2003
RESPS:1,273 HOURS:29,564 COSTS(000):$618
NSPS for Large Appliance Surface Coating -- 40 CFR Part 60,
Subpart SS
FORMS: 0659.07
OMB NO: 2060-0110 EXPIRATION DATE: 02/29/2004
RESPS:82 HOURS:5,351 COSTS(000):$232
NSPS Smelters: Subpart M - Secondary Brass and Bronze Production
Subpart P - Primary Copper; Subpart Q - Primary Zinc, Subpart R
- Primary Lead; Subpart S - Primary Aluminum Reduction Plants;
...
FORMS: 1604.06
OMB NO: 2060-0111 EXPIRATION DATE: 10/31/2004
RESPS:31 HOURS:3,002 COSTS(000):$327
NSPS Subpart NN Phosphate Rock Plants
FORMS: ICR-1078.06
OMB NO: 2060-0114 EXPIRATION DATE: 07/31/2003
RESPS:128 HOURS:19,098 COSTS(000):$689
NSPS - Wool Fiberglas Insulation Manufacturing Plants, 40 CFR
Part 60, Subpart PPP. NESHAP-MACT - Wool Fiberglass Manufactur-
ing Plants, 40 CFR Part 63, Subpart NNN
FORMS: 1160.06
OMB NO: 2060-0120 EXPIRATION DATE: 10/31/2004
RESPS:1,116 HOURS:114,036 COSTS(000):$74
NSPS Subparts KKK and LLL Standards of Performance for Onshore
Natural gas Processing Plants
FORMS: 1086.06
OMB NO: 2060-0121 EXPIRATION DATE: 10/31/2004
RESPS:6,514 HOURS:39,139 COSTS(000):$0
NSPS for Storage Vessels for Petroleum Liquids 40 CFR part 60,
subpart Ka
FORMS: 1050.07
OMB NO: 2060-0122 EXPIRATION DATE: 04/30/2003
RESPS:390 HOURS:15,463 COSTS(000):$15
NSPS for Coal Preparation Plants - Subpart Y
FORMS: 1062.07
OMB NO: 2060-0132 EXPIRATION DATE: 07/31/2005
RESPS:52 HOURS:1,178 COSTS(000):$18
Nonconformanace Penalties for Heavy-Duty Engines and Heavy-Duty
Vehicles, Including Light-Duty Trucks Reporting and
Recordkeeping Requirements
FORMS: 1285.05
OMB NO: 2060-0135 EXPIRATION DATE: 08/31/2005
RESPS:30,020 HOURS:111,308 COSTS(000):$856
Aftermarket Catalytic Converter Policy
FORMS: 1292.06
OMB NO: 2060-0150 EXPIRATION DATE: 01/31/2004
RESPS:9,200 HOURS:18,500 COSTS(000):$28
Registration of Fuels and Fuel Additives: Requirements for
Manufacturers (40 CFR 79)
FORMS: 309.10 3520-12 3250-13 3520-16 3520-13A
OMB NO: 2060-0156 EXPIRATION DATE: 10/31/2004
RESPS:79 HOURS:13,151 COSTS(000):$17
Standards of Performance for New Stationary Sources; Rubber Tire
Manufacturing, Subpart 40 CFR Part 60, Subpart BBB
FORMS: 1158.07
OMB NO: 2060-0161 EXPIRATION DATE: 02/29/2004
RESPS:3,093 HOURS:7,653 COSTS(000):$1,501
40 CFR 60.530 thru 60.539(b), New Source Performance Standards
for New Residential Wood Heaters (Subpart AAA)
FORMS: 1176.06
OMB NO: 2060-0162 EXPIRATION DATE: 07/31/2003
RESPS:121 HOURS:3,639 COSTS(000):$0
New Source Performance Standards (NSPS), 40 CFR Part 60, Subpart
TTT, Surface Coating of Plastic Parts for Business Machines
FORMS: 1093.06
OMB NO: 2060-0170 EXPIRATION DATE: 05/31/2005
RESPS:1,842 HOURS:7,357 COSTS(000):$0
Recordkeeping and Periodic Reporting of the Production, Import,
Recycling, Destruction, Transshipment and Feedstock Use of
Ozone- Depleting Substances
FORMS: 1432.21
OMB NO: 2060-0171 EXPIRATION DATE: 02/29/2004
RESPS:56 HOURS:3,891 COSTS(000):$93
New Source Performance Standards (NSPS) for Magnetic Tape Coat-
ing Facilities, 40 CFR Part 60, Subpart SSS
FORMS: 1135.07
OMB NO: 2060-0172 EXPIRATION DATE: 09/30/2004
RESPS:320 HOURS:36,866 COSTS(000):$57
NSPS 40 CFR Part 60, Subpart QQQ - Standards of Performance for
VOC Emissions form Petroleum Refinery Wastewater Systems - Re-
porting and Recordkeeping
FORMS: 1136.06
OMB NO: 2060-0178 EXPIRATION DATE: 12/31/2004
RESPS:3,000,002 HOURS:4,178 COSTS(000):$0
Regulation of Fuels and Fuel Additives: Gasoline Volatility:
Reporting Requirements (40 CFR 80.27)
FORMS: 1367.06
OMB NO: 2060-0181 EXPIRATION DATE: 01/31/2005
RESPS:173 HOURS:14,366 COSTS(000):$564
Standards of Performance for New Stationary Sources, Polymeric
Coating of Supporting Substrates Facilities, Subpart VVV
FORMS: 1284.06
OMB NO: 2060-0183 EXPIRATION DATE: 04/30/2003
RESPS:240 HOURS:17,028 COSTS(000):$0
Benzene Waste Operations -- NESHAP Subpart FF
FORMS: 1541.06
OMB NO: 2060-0185 EXPIRATION DATE: 08/31/2004
RESPS:76 HOURS:7,083 COSTS(000):$0
National Emission Standards for Hazardous Air Pollutants,
Benzene Emission from Benzene Storage Vessels and Coke
by-product re- covery plants. 40 CFR Part 61, Subparts L & Y
FORMS: 1080.10
OMB NO: 2060-0191 EXPIRATION DATE: 08/31/2005
RESPS:62 HOURS:5,812 COSTS(000):$231
National Emission Standards for Hazardous Air Pollutants:
Radionuclides - (40 CFR Part 61) Subparts B, H, K, R, and W.
FORMS: 1100.00
OMB NO: 2060-0202 EXPIRATION DATE: 10/31/2004
RESPS:1,696 HOURS:432,767 COSTS(000):$13,185
NSPS 40 CFR Part 60, Subpart Dc - Standards of Performance for
Small Industrial-Commercial-Institutional Steam Generating Units
FORMS: 1564.05
OMB NO: 2060-0210 EXPIRATION DATE: 04/30/2005
RESPS:50 HOURS:11,885 COSTS(000):$132
NSPS Municipal Waste Combustors (MWC) for Subpart Ea and Subpart
Eb
FORMS: 1506.09
OMB NO: 2060-0220 EXPIRATION DATE: 12/31/2005
RESPS:299 HOURS:3,390 COSTS(000):$107
NSPS for Municipal Solid Waste Landfills, 40 CFR Part 60,
Subpart WWW
FORMS: ICR-1557.05
OMB NO: 2060-0226 EXPIRATION DATE: 10/31/2004
RESPS:330 HOURS:10,363 COSTS(000):$45
Information Collection Activities: Significant New Alternatives
Policy (SNAP) Program Final Rulemaking under Title VI of the
Clean Air Act Amendments of 1990, 40 CFR part 82, Subpart G.
FORMS: 1596.05
OMB NO: 2060-0234 EXPIRATION DATE: 09/30/2003
RESPS:5,270 HOURS:1,212,129 COSTS(000):$47
NESHAP for Perchloroethylene (PCE) Dry Cleaning Facilities,
FORMS: 1415.04
OMB NO: 2060-0243 EXPIRATION DATE: 10/31/2004
RESPS:21,036 HOURS:4,779,620 COSTS(000):$0
Part 70 Operating Permits Regulations
FORMS: 1587.05
OMB NO: 2060-0247 EXPIRATION DATE: 09/30/2005
RESPS:35,020 HOURS:6,512 COSTS(000):$0
Stratospheric Ozone Protecton, Servicing of Motor Vehicle Air
Conditions, CFR 40 Subpart B (82.30 et. seq.)
FORMS: 1617.04
OMB NO: 2060-0249 EXPIRATION DATE: 10/31/2005
RESPS:82 HOURS:33,649 COSTS(000):$148
Air Pollution Regulations for Outer Continental Shelf Activities
FORMS: 1601.05 7610-12 7610-14
OMB NO: 2060-0251 EXPIRATION DATE: 12/31/2005
RESPS:342 HOURS:6,506 COSTS(000):$115
NSPS for Calciners and Dryers in Mineral Industries (40 CFR Part
60, Subpart UUU)
FORMS: 0746.05
OMB NO: 2060-0253 EXPIRATION DATE: 05/31/2005
RESPS:58 HOURS:104,659 COSTS(000):$0
National Emission Standards for Coke Oven Batteries, 40 CFR Part
63, Subpart L
FORMS: 1362.04
OMB NO: 2060-0256 EXPIRATION DATE: 07/31/2003
RESPS:2,342,047 HOURS:419,546 COSTS(000):$0
National Recycling and Emissions Reduction Program
FORMS: 1626.07
OMB NO: 2060-0258 EXPIRATION DATE: 04/30/2003
RESPS:10,085 HOURS:1,330,327 COSTS(000):$135,632
Information Collection Request for the Acid Rain Program under
Title IV of the Clean Air Act Amendments of 1990
FORMS: 1633.12
OMB NO: 2060-0264 EXPIRATION DATE: 06/30/2004
RESPS:4,555 HOURS:137,549 COSTS(000):$0
Application Requirements for the Approval and Delegation of
Federal Air Toxics Programs to State, Territorial, Local, and
Tribal Agencies
FORMS: 1643.04
OMB NO: 2060-0266 EXPIRATION DATE: 05/31/2005
RESPS:28,000 HOURS:172,200 COSTS(000):$0
Control Technology Determination for Equivalent Emission Limita-
tions by Permit
FORMS: 1648.04
OMB NO: 2060-0273 EXPIRATION DATE: 10/31/2003
RESPS:3,923 HOURS:45,207 COSTS(000):$4,091
NESHAP for Halogenated Solvent Cleaners/Halogenated Hazardous
Air Pollutants (40 CFR Part 63, subpart T)
FORMS: 1652.04
OMB NO: 2060-0275 EXPIRATION DATE: 10/31/2004
RESPS:69,558 HOURS:223,008 COSTS(000):$536
Detergent Gasoline: Certification Requirements for Manufac-
urers of Detergent Additives; Requirements for Transferors and
Transferees of Detergent Additives; Requirements for ...
FORMS: 1655.04
OMB NO: 2060-0277 EXPIRATION DATE: 04/30/2004
RESPS:53,171 HOURS:101,571 COSTS(000):$22,986
Regulation of Fuels and Fuel Additives: Reformulated Gasoline
Terminal Receipt Date
FORMS: 1591.14
OMB NO: 2060-0279 EXPIRATION DATE: 04/30/2005
RESPS:733 HOURS:10,246 COSTS(000):$0
General Conformity of Federal Actions to State Implemenation
Plan 40 CFR Part 51, Subpart W, Part 93, Subpart B
FORMS: 1637.05
OMB NO: 2060-0283 EXPIRATION DATE: 02/29/2004
RESPS:98 HOURS:7,328 COSTS(000):$228
NESHAP 40 CFR Part 63 Subpart O: National Emission Standards for
Hazardous Air Pollutants (NESHAP) for Commercial Ethylene Oxide
Sterilization and Fumigation Operations
FORMS: 1666.05
OMB NO: 2060-0287 EXPIRATION DATE: 09/30/2004
RESPS:779 HOURS:89,047 COSTS(000):$4,089
Non-road Compression-Ignition Engine and On-Highway Heavy Duty
Engine Application for Emissions Certification, and
Participation in the Averaging, Banking, and Trading Program 40
Part 86.094,...
FORMS: 1684.05
OMB NO: 2060-0289 EXPIRATION DATE: 05/31/2005
RESPS:105 HOURS:28,131 COSTS(000):$0
Federal Standards for Marine Tank Vessel Loading Operations and
National Emission Standards for Hazardous Air Pollutants for
Marine Tank Vessel Loading Operations.(40 CFR Part 63, Subpart Y)
FORMS: 1679.04
OMB NO: 2060-0290 EXPIRATION DATE: 09/30/2004
RESPS:29 HOURS:4,525 COSTS(000):$9
NESHAP: Epoxy Resin and Non-Nylon Polyamide Production - Subpart
W
FORMS: 1681.04
OMB NO: 2060-0294 EXPIRATION DATE: 08/31/2003
RESPS:150,215 HOURS:75,393 COSTS(000):$4,686
Reporting and Recordkeeping Requirements for Importation of
Nonconforming Nonroad Compression Ignition (CI) & Small Spark
Ignition (SI) Engines
FORMS: 1673.02 3520-1 3520-8 3520-14
OMB NO: 2060-0296 EXPIRATION DATE: 10/31/2003
RESPS:70 HOURS:16,033 COSTS(000):$150
NESHAP for the Secondary Lead Smelter Industry
FORMS: 1686.04
OMB NO: 2060-0297 EXPIRATION DATE: 05/31/2003
RESPS:3 HOURS:67,467 COSTS(000):$6,500
Registration of Fuels and Fuel Additives: Health-Effects
Research Requirements for Manufacturers -- 40 CFR 79, Subpart F
FORMS: 1696.03
OMB NO: 2060-0302 EXPIRATION DATE: 11/30/2004
RESPS:188 HOURS:3,709 COSTS(000):$106
Retrofit/Rebuild Requirements for 1993 and Earlier Model Year
Urban Buses, 40 CFR Part 85
FORMS: 1702.03
OMB NO: 2060-0306 EXPIRATION DATE: 10/31/2004
RESPS:7 HOURS:293 COSTS(000):$0
Clean Air Act Tribal Authority
FORMS: 1676.03
OMB NO: 2060-0308 EXPIRATION DATE: 09/30/2004
RESPS:400,000 HOURS:222 COSTS(000):$0
Tax-exempt (Dyed) Highway Diesel Fuel; Requirements for
Transferors and Transferees
FORMS: 1718.03
OMB NO: 2060-0313 EXPIRATION DATE: 01/31/2004
RESPS:1,000 HOURS:162,050 COSTS(000):$0
National Emission Standards for Hazardous Air Pollutants
(NESHAP) for for-Site Waste and Recovery Operations (Subpart DD)
FORMS: 1717.03
OMB NO: 2060-0314 EXPIRATION DATE: 05/31/2004
RESPS:16,402 HOURS:3,737,400 COSTS(000):$561
40 CFR 63 Subpart GG NESHAP, Aerospace Manufacturing and Rework
FORMS: 1687.05
OMB NO: 2060-0318 EXPIRATION DATE: 07/31/2004
RESPS:6,318 HOURS:672,640 COSTS(000):$1,460
Standards of Performance for Air Emission Standards for Tanks,
Surface Impoundments and Containers, 40 CFR Part 264, Subpart CC
and 40 CFR Part 265.
FORMS: 1593.05
OMB NO: 2060-0320 EXPIRATION DATE: 11/30/2004
RESPS:3,100 HOURS:1,550 COSTS(000):$78
Importation of Nonconforming Marine Engines: Reporting and
Record keeping Requirements
FORMS: 1723.03
OMB NO: 2060-0321 EXPIRATION DATE: 09/30/2004
RESPS:254 HOURS:38,674 COSTS(000):$2
Spark-ignition Marine Engine Application for Emission
Certification and Participation in the Averaging, Banking, and
Trading Program 40 CFR Part 91, Subpart B and C
FORMS: 1722.03
OMB NO: 2060-0322 EXPIRATION DATE: 10/31/2004
RESPS:68 HOURS:10,405 COSTS(000):$694
Marine Engine Manufacturer In-use Emission Testing Program Re-
porting and Recordkeeping, 40 CFR Part 91, Subpart N
FORMS: 1726.03
OMB NO: 2060-0323 EXPIRATION DATE: 09/30/2004
RESPS:340 HOURS:19,300 COSTS(000):$2,821
Marine Engine Manufacturer Production Line Testing Reporting and
Recordkeeping Requirements, 40 CFR Part 91
FORMS: 1725.03
OMB NO: 2060-0324 EXPIRATION DATE: 02/29/2004
RESPS:47,800 HOURS:92,071 COSTS(000):$41
National Emission Standards for Hazardous Air Pollutants
(NESHAP) from Wood Furniture Manufacturing Operations. 40 CFR
Part 63, Subpart JJ
FORMS: 1716.03
OMB NO: 2060-0325 EXPIRATION DATE: 02/29/2004
RESPS:526 HOURS:32,575 COSTS(000):$851
National Emission Standards for Hazardous Air Pollutants for
FORMS: 1659.04
OMB NO: 2060-0326 EXPIRATION DATE: 01/31/2004
RESPS:26 HOURS:7,042 COSTS(000):$89
NESHAP, Magnetic Tape Manufacturing Operations, 40 CFR Part 63,
Subpart EE
FORMS: 1678.04
OMB NO: 2060-0327 EXPIRATION DATE: 02/29/2004
RESPS:1,896 HOURS:516,186 COSTS(000):$75,300
NESHAP for Chromium Emissions from Hard and Decorative Chromium
Electroplating and Chromium Anodizing Tanks 40 CFR Part 63
(Subpart N)
FORMS: 1611.04
OMB NO: 2060-0328 EXPIRATION DATE: 11/30/2004
RESPS:120 HOURS:4,059 COSTS(000):$1
EPA's Natural Gas STAR Program
FORMS: 1763.03
OMB NO: 2060-0330 EXPIRATION DATE: 08/31/2003
RESPS:45 HOURS:22,149 COSTS(000):$0
National Emissions Standards for Hazardous Air Pollutants for
Shipbuilding and Ship Repair Facilities (Surface Coating) CFR 40
Part 63, Subpart Ii
FORMS: 1712.03
OMB NO: 2060-0335 EXPIRATION DATE: 09/30/2003
RESPS:273 HOURS:52,495 COSTS(000):$403
MACT Subpart KK, National Emission Standards for the Printing
and Publishing Industry
FORMS: 1739.03
OMB NO: 2060-0336 EXPIRATION DATE: 10/31/2004
RESPS:3,179 HOURS:15,323 COSTS(000):$0
Information Collection Request for Part 71 Federal Operating
Permit Regulations
FORMS: 1713.04
OMB NO: 2060-0337 EXPIRATION DATE: 10/31/2004
RESPS:53 HOURS:2,120 COSTS(000):$0
State Small Business Stationary Source Technical and Environ-
mental Compliance Assistance Program Annual Reporting Form
FORMS: 1748.03
OMB NO: 2060-0338 EXPIRATION DATE: 09/30/2004
RESPS:653 HOURS:47,736 COSTS(000):$3,240
Certification and the Averaging, Banking, and Trading Program
for Non-road Spark-Ingnition Engines at or Below 19 Kilowatts,
40 Part 90, Subpart C
FORMS: 1695.07
OMB NO: 2060-0340 EXPIRATION DATE: 12/31/2004
RESPS:314 HOURS:469,430 COSTS(000):$542
NESHAP for Petroleum Refineries, 40 CFR Part 63, Subpart CC
FORMS: 1692.04
OMB NO: 2060-0345 EXPIRATION DATE: 09/30/2004
RESPS:18 HOURS:4,338 COSTS(000):$0
Regulations for a Voluntary Emissions Standards Program
Applicable to Manufacturers of Light-Duty Vehicles and Trucks
Beginning in Model Year 1997 - 40 CFR 86.1700
FORMS: 1761.03
OMB NO: 2060-0347 EXPIRATION DATE: 04/30/2003
RESPS:15,529 HOURS:217,714 COSTS(000):$15
Information Collection Activities Associated with EPA's Energy
Star Buildings Program
FORMS: ICR1772.02
OMB NO: 2060-0348 EXPIRATION DATE: 06/30/2003
RESPS:375 HOURS:29,695 COSTS(000):$0
Reporting and Recordkeeping Requirements for National Volatile
Organic Compound Emission Standards for Consumer products CFR 40
Part 59, Subpart C
FORMS: 1764.02
OMB NO: 2060-0350 EXPIRATION DATE: 09/30/2003
RESPS:5,000,000 HOURS:416,667 COSTS(000):$500
Mobile Air Conditioner Retrofitting Program, 40 CFR Part 82.180
FORMS: 1774.02
OMB NO: 2060-0353 EXPIRATION DATE: 06/30/2003
RESPS:10 HOURS:22 COSTS(000):$0
Reporting and Recordkeeping Requirements for National Volatile
Organic Compound Emission Standards for Automobile Refinish
Coatings CFR 40 Part 59 Subpart B
FORMS: 1765.02
OMB NO: 2060-0357 EXPIRATION DATE: 01/31/2004
RESPS:143 HOURS:6,400 COSTS(000):$0
MACT - Flexible Polyurethane Foam Product, 40 CFR Part 63,
Subpart III
FORMS: 1783.02
OMB NO: 2060-0358 EXPIRATION DATE: 02/29/2004
RESPS:209 HOURS:161,326 COSTS(000):$8
National Emission Standard for Hazardous Air Pollutants for
Source Categories; Pharmaceutical Production, 40 CFR Part 63,
Subpart GGG
FORMS: 1781.02
OMB NO: 2060-0360 EXPIRATION DATE: 09/30/2004
RESPS:50 HOURS:121,277 COSTS(000):$117
MACT for Primary Aluminum Reduction Plants, 40 CFR, Subpart L.
FORMS: 1767.03
OMB NO: 2060-0361 EXPIRATION DATE: 01/31/2004
RESPS:193 HOURS:4,143 COSTS(000):$66
NESHAP - Phosphoric Acid Manufacturing and Phosphate Fertilizers
Production, 40 CFR Part 63, Subparts AA and BB
FORMS: 1790.02
OMB NO: 2060-0362 EXPIRATION DATE: 01/31/2004
RESPS:26 HOURS:5,779 COSTS(000):$100
NESHAP/MACT 40 CFR Part 63, Subpart DDD - Mineral Wool Produc-
tion
FORMS: 1799.02
OMB NO: 2060-0363 EXPIRATION DATE: 11/30/2004
RESPS:2,349 HOURS:4,541 COSTS(000):$19
Standards of Performance for New Stationary Sources: Hospital/
Medical/Infectious Waste Incinerators, 40 CFR Part 60, Subpart Ec
FORMS: 1730.03
OMB NO: 2060-0369 EXPIRATION DATE: 09/30/2004
RESPS:205 HOURS:66,647 COSTS(000):$19
Transition Program for Equipment Manufacturers, 40 CFR Part 89.
101
FORMS: 1862.02
OMB NO: 2060-0370 EXPIRATION DATE: 10/31/2004
RESPS:375 HOURS:53,752 COSTS(000):$2,268
National Emissions Standards for Hazardous Air Pollutants-
Pesticide Active Ingredient Production, 40 CFR Part 63, Subpart
MMM
FORMS: ICR#1807.2
OMB NO: 2060-0373 EXPIRATION DATE: 10/31/2004
RESPS:600 HOURS:92,210 COSTS(000):$0
Control Technology Determinations for Constructed or Reconstruc-
ted Major Sources of Hazardous Air Pollutants, 40 CFR Part 63,
Subpart B
FORMS: 1658.03
OMB NO: 2060-0376 EXPIRATION DATE: 11/30/2004
RESPS:4,040 HOURS:172,698 COSTS(000):$9,699
Information Collection Request Update for the 40 CFR Part 64
Compliance Assurance Monitoring Program
FORMS: 1663.03
OMB NO: 2060-0377 EXPIRATION DATE: 12/31/2004
RESPS:125 HOURS:21,528 COSTS(000):$5
National Emission Standards for Hazardous Air Polluants for
Chemical Recovery Combustion Sources at Kraft, Soda, Sulfite,
and Stand-Alone Semichemical Pulp Mills
FORMS: 1805.03
OMB NO: 2060-0382 EXPIRATION DATE: 11/30/2004
RESPS:25 HOURS:14,950 COSTS(000):$139
PFC Emission Reduction Partnership for the Semiconductor
Industry, Non Rule Related, Memo of Understanding
FORMS: 1823.02
OMB NO: 2060-0387 EXPIRATION DATE: 11/30/2004
RESPS:500 HOURS:50,232 COSTS(000):$370
NESHAP for Total HAP Emissions form the Pulp Paper Production
Source Category - Process Operations, 40 CFR Part 63, Subpart S.
FORMS: 1657.04
OMB NO: 2060-0390 EXPIRATION DATE: 04/30/2003
RESPS:112 HOURS:58,915 COSTS(000):$3,218
Federal Plan Recordkeeping and Reporting Requirements for Large
Municipal Waste Combustors Constructed on or Before September
20, 1994 (Subpart FFF)
FORMS: 1847.02
OMB NO: 2060-0391 EXPIRATION DATE: 12/31/2004
RESPS:20 HOURS:746 COSTS(000):$0
NESHAP for Ferroalloys Production
FORMS: EPA-ICR-1831.02
OMB NO: 2060-0392 EXPIRATION DATE: 12/31/2004
RESPS:67 HOURS:11,121 COSTS(000):$388
Information Requirements for Locomotives and Locomotive Engines
FORMS: 1800.02
OMB NO: 2060-0393 EXPIRATION DATE: 04/30/2005
RESPS:745 HOURS:23,411 COSTS(000):$0
National Volatile Organic Compound Emission Standards for
Architechural Coatings
FORMS: 1750.03
OMB NO: 2060-0394 EXPIRATION DATE: 11/30/2004
RESPS:1 HOURS:8 COSTS(000):$0
National Emission Standards for Hazardous Air Pollutants for
Beryllium Rocket Motor Firing 40 CFR part 61, Subpart D.
FORMS: 1125.03
OMB NO: 2060-0395 EXPIRATION DATE: 08/31/2005
RESPS:12 HOURS:69 COSTS(000):$1
Exclucion Determinations for New Non-road Spark-ignited Engines
at or Below 19 Kilowats, New Non-road Compressionigintied
Engines New Marine Engines, and New on-raod Heavy Duty Engines
(40 CFR 85
FORMS: EPA-1852.02
OMB NO: 2060-0411 EXPIRATION DATE: 12/31/2005
RESPS:8 HOURS:584 COSTS(000):$0
Voluntary Aluminum Industrial Partnership (VAIP)
FORMS: 1867.02
OMB NO: 2060-0414 EXPIRATION DATE: 10/31/2005
RESPS:4 HOURS:12,246 COSTS(000):$40
National Emission Standard for Hazardous Air Pollutants (NESHAP)
for Primary Lead Smelters (40 CFR Part 63, Subpart TTT)
FORMS: 1856.03
OMB NO: 2060-0415 EXPIRATION DATE: 09/30/2005
RESPS:158 HOURS:88,680 COSTS(000):$513
NESHAP for Polyether Polyols Production (40 CFR part 63, Subpart
PPP)
FORMS: 1811.03
OMB NO: 2060-0416 EXPIRATION DATE: 10/31/2005
RESPS:214 HOURS:53,181 COSTS(000):$685
NESHAP for the Portland Cement Manufacturing Industry (40 CFR
Part 63, Subpart LLL)
FORMS: 1801.03
OMB NO: 2060-0417 EXPIRATION DATE: 08/31/2005
RESPS:996 HOURS:29,489 COSTS(000):$567
NESHAP: Oil and Natural Gas Production (40 CFR part 63, Subpart
HH)
FORMS: 1788.03
OMB NO: 2060-0418 EXPIRATION DATE: 09/30/2005
RESPS:14 HOURS:581 COSTS(000):$0
NESHAP: Natural Gas Transmission and Storage Facilities (40 CFR
Part 63, Subpart HHH)
FORMS: 1789.03
OMB NO: 2060-0419 EXPIRATION DATE: 10/31/2005
RESPS:231 HOURS:25,104 COSTS(000):$9
National Emission Standard for Hazardous Air Pollutants (NESHAP)
for Steel Pickling. (40 CFR, Subpart PPP)
FORMS: 1821.03
OMB NO: 2060-0420 EXPIRATION DATE: 12/31/2005
RESPS:30 HOURS:4,077 COSTS(000):$107
National Emission Standards for Hazardous Air Pollutants for
Source Categories: Generic Maximum Achievable Control Technology
(40 CFR Part 63, Subpart YY)
FORMS: 1871.03
OMB NO: 2060-0421 EXPIRATION DATE: 04/30/2003
RESPS:51 HOURS:11,500 COSTS(000):$0
Final Regional Haze Rule
FORMS: 1813.02
OMB NO: 2060-0422 EXPIRATION DATE: 04/30/2003
RESPS:1,146 HOURS:133,404 COSTS(000):$0
Reporting and Recordkeeping Requirements for the Emission
Guidelines for Hospital/Medical/Infectious Waste Incinerators
FORMS: 1899.01
OMB NO: 2060-0423 EXPIRATION DATE: 04/30/2003
RESPS:6 HOURS:8,559 COSTS(000):$219
Reporting and Recordkeeping Requirements for the New Source
Performance Standards for Small Municipal Waste Combustors --
Subpart AAAA
FORMS: 1900.01
OMB NO: 2060-0424 EXPIRATION DATE: 04/30/2003
RESPS:90 HOURS:1,297 COSTS(000):$0
Emission Guidelines Reporting and Recordkeeping Requirements for
Existing Small Municipal Waste Combustion (MWC) Units
FORMS: 1901.01
OMB NO: 2060-0425 EXPIRATION DATE: 01/31/2004
RESPS:176 HOURS:1,256 COSTS(000):$1
Emission Defect Information and Voluntary Emission Recall
Reports for On-Highway, Light-Duty Vehicles
FORMS: 1916.01
OMB NO: 2060-0427 EXPIRATION DATE: 10/31/2003
RESPS:200 HOURS:80,383 COSTS(000):$0
Small Spark Ignition Manufacturers Production Line Testing
FORMS: 1845.02
OMB NO: 2060-0428 EXPIRATION DATE: 04/30/2003
RESPS:41 HOURS:41 COSTS(000):$0
NESHAP for Source Category: Publicly Owned Treatment Works
FORMS: 1891.02
OMB NO: 2060-0430 EXPIRATION DATE: 04/30/2003
RESPS:384 HOURS:15,110 COSTS(000):$890
Federal Emission Guidelines for Existing Municipal Solid Waste
Landfills
FORMS: 1893.02
OMB NO: 2060-0433 EXPIRATION DATE: 07/31/2003
RESPS:2,315 HOURS:148,031 COSTS(000):$687
Recordkeeping and Reporting Requirements for the Secondary
Aluminum Production - NESHAP
FORMS: 1894.02
OMB NO: 2060-0434 EXPIRATION DATE: 02/29/2004
RESPS:80 HOURS:32,252 COSTS(000):$80
National Emission Standard for Hazardous Air Pollutants: Manu-
facture of Amino/Phenolic Resins
FORMS: 1869.02
OMB NO: 2060-0436 EXPIRATION DATE: 09/30/2003
RESPS:3,112 HOURS:5,602 COSTS(000):$38
Indoor Air Quality Practices in Large Buildings Survey
FORMS: 1917.01
OMB NO: 2060-0437 EXPIRATION DATE: 01/31/2004
RESPS:192,268 HOURS:12,532 COSTS(000):$0
Recordkeeping and Reporting Requirements Regarding the Sulfur
Content of Motor Vehicle Gasoline Under the Tier 2 Rule.
FORMS: 1907.02
OMB NO: 2060-0439 EXPIRATION DATE: 11/30/2003
RESPS:5,000 HOURS:1,667 COSTS(000):$0
Information Collection Request: The Sun Wise School Program
FORMS: 1904.01
OMB NO: 2060-0442 EXPIRATION DATE: 01/31/2004
RESPS:4 HOURS:678 COSTS(000):$0
NSPS Subpart K, Storage Vessels for Petroleum Liquids for Which
Construction, Reconstruction, or Modification Commenced after
June 11.
FORMS: 1797.02
OMB NO: 2060-0443 EXPIRATION DATE: 08/31/2005
RESPS:10,361 HOURS:2,165,600 COSTS(000):$99,921
Synthetic Organic Chemical Industry (SOCMI): Consolidation of
Information Collection Request (Revision)
FORMS: 1854.03
OMB NO: 2060-0445 EXPIRATION DATE: 10/31/2003
RESPS:3,982 HOURS:284,746 COSTS(000):$15,686
Emission Reporting Requirements for Ozone SIP Revisions (or
Associated Federal Implementation Plans) Relating to Statewide
Budgets for NOx Emissions to Reduce the Regional Transport of OZ.
FORMS: 1857.02
OMB NO: 2060-0446 EXPIRATION DATE: 10/31/2003
RESPS:323 HOURS:1,484 COSTS(000):$1
Landfill Methane Outreach Program
FORMS: 1849.01
OMB NO: 2060-0450 EXPIRATION DATE: 01/31/2004
RESPS:18 HOURS:11,209 COSTS(000):$14
Reporting and Recordkeeping Requirements for Standards of
Performance for New Stationary Sources: Commercial and Indus-
trial Solid Waste Incineration (CISWI) Units (Subpart CCC).
FORMS: 1926.02
OMB NO: 2060-0451 EXPIRATION DATE: 01/31/2004
RESPS:116 HOURS:9,145 COSTS(000):$0
Reporting and Recordkeeping Requirements for the Emission
Guidelines for Existing Commercial and Industrial Solid Waste
Incineration (CISWI) Units (Subpart DDDD).
FORMS: 1927.02
OMB NO: 2060-0460 EXPIRATION DATE: 10/31/2004
RESPS:30 HOURS:53,791 COSTS(000):$5,219
Information Requirements for Marine Diesel Engines (Nonroad
Large SI Engines and Marine Diesel Engines)(Amendments) (Final
Rule)
FORMS: 1897.04
OMB NO: 2060-0463 EXPIRATION DATE: 07/31/2004
RESPS:806 HOURS:564 COSTS(000):$0
IAQ Practices in Schols Survey
FORMS: 1885.01
OMB NO: 2060-0471 EXPIRATION DATE: 01/31/2005
RESPS:75 HOURS:10,092 COSTS(000):$0
National Emission Standards for Hazardous Air Pollutants:
Solvent Extraction for Vegetable Oil Production
FORMS: 1947.02
OMB NO: 2060-0476 EXPIRATION DATE: 05/31/2005
RESPS:90 HOURS:20,506 COSTS(000):$98
NESHAP: Primary Copper Smelters
FORMS: 1850.03
OMB NO: 2060-0478 EXPIRATION DATE: 06/30/2005
RESPS:12 HOURS:485 COSTS(000):$0
National Emission Standards for Hazardous Air Pollutants
(NESHAP) for Leather Finishing Operations
FORMS: 1985.02
OMB NO: 2060-0481 EXPIRATION DATE: 07/31/2005
RESPS:5 HOURS:1 COSTS(000):$2
Reporting and Recordkeeping Requirements for the Friction
Materials Manufacturing NESHAP
FORMS: 2025.01
OMB NO: 2060-0482 EXPIRATION DATE: 05/31/2005
RESPS:275 HOURS:97,605 COSTS(000):$99
Protection of Stratospheric Ozone: Request for Applications for
Critical use Exemptions from the Phaseout of Methyl Bromide
FORMS: 2031.01
OMB NO: 2060-0483 EXPIRATION DATE: 07/31/2005
RESPS:74 HOURS:1 COSTS(000):$2
National Emission Standards for Hazardous Air Pollutants for
Engine Test Cells/Stands.
FORMS: 2066.01
OMB NO: 2060-0486 EXPIRATION DATE: 08/31/2005
RESPS:180 HOURS:139,380 COSTS(000):$3
National Emission Standards for Hazardous Air Pollutants:
Miscellaneous Metal Parts and Products Surface Coating Operations
FORMS: 2056.01
OMB NO: 2060-0487 EXPIRATION DATE: 08/31/2005
RESPS:241 HOURS:25,048 COSTS(000):$236
Reporting and Recordkeeping Requirements for Metal Coil Surface
Coating Plants
FORMS: 1957.02
OMB NO: 2060-0488 EXPIRATION DATE: 08/31/2005
RESPS:9 HOURS:1,436 COSTS(000):$56
National Emission Standards for Hazardous Air Pollutants for
Cellulose Products Manufacturing (Final Rule)
FORMS: 1974.02
OMB NO: 2060-0489 EXPIRATION DATE: 08/31/2005
RESPS:275 HOURS:33,926 COSTS(000):$4,917
NESHAP for Source Categories: Generic Maximum Achievable Control
Technology Standards (Final Rule)
FORMS: 1983.02
OMB NO: 2060-0490 EXPIRATION DATE: 08/31/2005
RESPS:52,591 HOURS:726 COSTS(000):$0
National Survey on Environmental Management of Asthma
FORMS: 1996.01
OMB NO: 2060-0496 EXPIRATION DATE: 12/31/2005
RESPS:14 HOURS:2,983 COSTS(000):$2
Reporting & Recordkeeping Requirements of the National Emission
Standard for Hazardous Air Pollutants from Wet-formed Fiberglass
Mat Production Industry
FORMS: 1964.02
OMB NO: 2060-0502 EXPIRATION DATE: 02/28/2006
RESPS:1,000 HOURS:417 COSTS(000):$9,230
Eliciting Risk Tradeoffs for Valuing Fatal Cancer Risks
FORMS: 2057.01
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
184 11,759,344 30,373,802 $584,884
Office of Prevention, Pesticides and Toxic Substances
OMB NO: 2070-0004 EXPIRATION DATE: 02/28/2006
RESPS:495 HOURS:2,344 COSTS(000):$0
Health and Safety Data Reporting; Submission of Lists and Copies
of Health and Safety Studies
FORMS: 0575.09
OMB NO: 2070-0012 EXPIRATION DATE: 07/31/2004
RESPS:1,674 HOURS:184,608 COSTS(000):$0
Pre-Manufacture Review Reporting and Exemption Requirements for
New Chemical Substances and Significant New Use Reporting
Requirements for Chemical Substances.
FORMS: 7710-25 7710-56 574.11
OMB NO: 2070-0017 EXPIRATION DATE: 12/31/2005
RESPS:7,397 HOURS:29,939 COSTS(000):$0
Recordkeeping and Reporting Requirements for Allegations of
Significant Adverse Reactions to Human Health or the Environment
(TSCA Section 8(c))
FORMS: 1031.07
OMB NO: 2070-0020 EXPIRATION DATE: 01/31/2006
RESPS:18,500 HOURS:5,550 COSTS(000):$0
Notice of Arrival of Pesticides and Devices (FIFRA)
FORMS: 0152.07 3540-1
OMB NO: 2070-0024 EXPIRATION DATE: 04/30/2003
RESPS:150 HOURS:258,900 COSTS(000):$0
Tolerance Petitions for Pesticides on Food/Feed Crops and New
Inert Ingredients
FORMS: 0597.07
OMB NO: 2070-0027 EXPIRATION DATE: 01/31/2006
RESPS:2,500 HOURS:24,753 COSTS(000):$0
Foreign Purchaser Acknowledgment Statement of Unregistered
Pesticides
FORMS: 0161.09
OMB NO: 2070-0028 EXPIRATION DATE: 10/31/2004
RESPS:12,336 HOURS:24,672 COSTS(000):$0
Recordkeeping Requirements for Producers of Pesticides under
Section 8 of the Federal Insecticide, Pungicide, and Rodenticide
Act (FIFRA)
FORMS: 0143.07
OMB NO: 2070-0029 EXPIRATION DATE: 08/31/2004
RESPS:413,293 HOURS:1,285,865 COSTS(000):$0
Certification of Pesticide Applicators
FORMS: 0155.07 8500-17
OMB NO: 2070-0030 EXPIRATION DATE: 04/30/2003
RESPS:11,000 HOURS:10,400 COSTS(000):$0
Notification of Chemical Exports -- TSCA Section 12(b)
FORMS: 0795.10
OMB NO: 2070-0032 EXPIRATION DATE: 11/30/2004
RESPS:600 HOURS:59,400 COSTS(000):$0
Application and Summary Report for Emergency Exemption for
Pesticides
FORMS: 0596.07
OMB NO: 2070-0033 EXPIRATION DATE: 10/31/2004
RESPS:17,299 HOURS:1,182,574 COSTS(000):$0
TSCA Section 4 Test Rules, Consent Orders, Test Rule Exemptions,
and Voluntary Data Submission
FORMS: 1139.06
OMB NO: 2070-0038 EXPIRATION DATE: 01/31/2006
RESPS:8 HOURS:1,020 COSTS(000):$0
TSCA Section 5(a)(2) Significant New Use Rules for Existing
Chemicals
FORMS: 1188.07 7710-25
OMB NO: 2070-0039 EXPIRATION DATE: 01/31/2004
RESPS:260 HOURS:166,266 COSTS(000):$0
Submission of Unreasonable Adverse Effects Information Under
FIFRA Section 6(a)(2)
FORMS: 1204.08
OMB NO: 2070-0040 EXPIRATION DATE: 09/30/2003
RESPS:75 HOURS:757 COSTS(000):$0
Application for Experimental use Permit (EUP) to Ship and Use a
Pesticide for Experimental Purposes Only
FORMS: 0276.11 8570-17
OMB NO: 2070-0044 EXPIRATION DATE: 10/31/2003
RESPS:5,000 HOURS:1,250 COSTS(000):$0
Notice of Supplemental Distribution of a Registered Pesticide
Product
FORMS: 0278.07 8570-05
OMB NO: 2070-0046 EXPIRATION DATE: 04/30/2003
RESPS:467 HOURS:8,209 COSTS(000):$0
Notification of Substantial Risk of Injury to Health and the
Environment under TSCA Secton 8(e)
FORMS: EPA-0794-09
OMB NO: 2070-0052 EXPIRATION DATE: 01/31/2004
RESPS:502 HOURS:853 COSTS(000):$0
Compliance Requirements for Child Resistant Packaging
FORMS: EPA-616.07
OMB NO: 2070-0054 EXPIRATION DATE: 10/31/2004
RESPS:118 HOURS:3,355 COSTS(000):$5
TSCA Section 8(a) Preliminary Assessment Information Rule (PAIR)
FORMS: 0586.09 7710-35 7710-51
OMB NO: 2070-0055 EXPIRATION DATE: 01/31/2006
RESPS:350 HOURS:18,200 COSTS(000):$0
Notice of Pesticide Registration by States to Meet a Special
Local Need (SLN) Under FIFRA Section 24(c)
FORMS: 0595.08 8570-25 8570-4
OMB NO: 2070-0057 EXPIRATION DATE: 08/31/2004
RESPS:68 HOURS:71,132 COSTS(000):$0
Data Call-Ins for the Special Review and Registration Review
Programs
FORMS: 0922.06 8570-32
OMB NO: 2070-0060 EXPIRATION DATE: 10/31/2005
RESPS:7,021 HOURS:152,974 COSTS(000):$0
Application for New and Amended Pesticide Registration
FORMS: 0277.13 8570-1 8570-4 8570-27 8570-34 8570-35 8570-36 8570-37
OMB NO: 2070-0067 EXPIRATION DATE: 04/30/2004
RESPS:4 HOURS:275 COSTS(000):$0
Chemical-Specific Rules, TSCA section 8(a)
FORMS: 1198.06
OMB NO: 2070-0070 EXPIRATION DATE: 11/30/2004
RESPS:3,000 HOURS:65,640 COSTS(000):$0
Partial Updating of TSCA Inventory Data Base, Production and
FORMS: 1011.05 7740-8
OMB NO: 2070-0072 EXPIRATION DATE: 07/31/2004
RESPS:1,272,138 HOURS:436,289 COSTS(000):$0
Rule Related Replacement ICR to the Existing ICR entitled
"Reporting and Recordkeeping for Asbestos Abatement Worker
Protection"
FORMS: ICR(1246.08)
OMB NO: 2070-0074 EXPIRATION DATE: 09/30/2003
RESPS:84 HOURS:3,353 COSTS(000):$0
Recordkeeping for Certified Applicators Using 1080 Collars for
Livestock Protection
FORMS: 1249.06
OMB NO: 2070-0075 EXPIRATION DATE: 02/29/2004
RESPS:432 HOURS:675 COSTS(000):$0
Request for Contractor Access to TSCA Confidential Business
Information
FORMS: 1250.06 7740-6 7700
OMB NO: 2070-0078 EXPIRATION DATE: 07/31/2005
RESPS:12,412 HOURS:17,959 COSTS(000):$0
Psticide Registration Application, Notification and Report for
Pesticide-Producing Establishments
FORMS: 3540-8 3540-8A 3540-16
OMB NO: 2070-0091 EXPIRATION DATE: 10/31/2004
RESPS:107,551 HOURS:2,212,151 COSTS(000):$0
Asbestos-Containing Materials in Schools Rule and Asbestos Model
Accreditation Plan Rule (MAP)
FORMS: 1365.06
OMB NO: 2070-0093 EXPIRATION DATE: 10/31/2003
RESPS:88,117 HOURS:5,566,564 COSTS(000):$0
Toxic Chemical Release Reporting, Recordkeeping, Supplier
Notification and Petitions under Section 313 of the Emergency
Planning and Community Right-to-Know Act (EPCRA): Renewal
FORMS: ICR-1363-12 9350-1
OMB NO: 2070-0100 EXPIRATION DATE: 01/31/2004
RESPS:1,977 HOURS:1,858 COSTS(000):$0
Pesticide Product Registration Maintenance Fee
FORMS: 1214.05 8570-30
OMB NO: 2070-0107 EXPIRATION DATE: 09/30/2004
RESPS:30 HOURS:90,725 COSTS(000):$0
Data Generation for Pesticide Reregistration
FORMS: 1504.04 8570-32 8570-34
OMB NO: 2070-0112 EXPIRATION DATE: 08/31/2004
RESPS:1,300,240 HOURS:741,261 COSTS(000):$0
PCBs: Consolidated Reporting and Recordkeeping Requirements
FORMS: 1446.07 7710-53 7720-12
OMB NO: 2070-0122 EXPIRATION DATE: 12/31/2004
RESPS:20 HOURS:117,256 COSTS(000):$0
Data Acquisition for Registration
FORMS: 1503.04
OMB NO: 2070-0142 EXPIRATION DATE: 07/31/2004
RESPS:15 HOURS:1,370 COSTS(000):$0
Plant-Incorporated Protectants; CBI Substantiation and Adverse
Effects Reporting
FORMS: 1693.02
OMB NO: 2070-0143 EXPIRATION DATE: 10/31/2003
RESPS:5,121 HOURS:463,670 COSTS(000):$0
Alternative Threshold for Low Annual Reportable Amounts; Toxic
Chemical Release Reporting Under Section 313 of the Emergency
Planning and Community Right-to-know Act (EPCRA): Renewal
FORMS: ICR-1704-06 9350-2
OMB NO: 2070-0145 EXPIRATION DATE: 01/31/2005
RESPS:200 HOURS:200 COSTS(000):$0
Correction of Misreported Chemical Substances on the Toxic
Substances Control Act (TSCA) Chemical Substances Inventory
FORMS: 7710-3C 1741.03
OMB NO: 2070-0148 EXPIRATION DATE: 02/28/2005
RESPS:4,476,250 HOURS:2,294,625 COSTS(000):$0
Worker Protection Standard Training and Notification
FORMS: 1759.03
OMB NO: 2070-0151 EXPIRATION DATE: 07/31/2004
RESPS:12,359,721 HOURS:7,145,412 COSTS(000):$0
Residential Lead-Based Paint Hazard Disclosure Requirements
FORMS: 1710.03
OMB NO: 2070-0155 EXPIRATION DATE: 08/31/2004
RESPS:21,528 HOURS:371,214 COSTS(000):$0
TSCA Section 402 and Section 404 Training and Certification,
Accreditiation and Standards for Lead-Based Paint Activities
FORMS: 1715.03
OMB NO: 2070-0156 EXPIRATION DATE: 02/29/2004
RESPS:1,830 HOURS:915 COSTS(000):$0
Voluntary Cover Sheet for TSCA Submissions
FORMS: 1780.02
OMB NO: 2070-0158 EXPIRATION DATE: 12/31/2004
RESPS:3,046,000 HOURS:2,938,546 COSTS(000):$9,231
Lead-based Paint Pre-Renovation Information Dissemination - TSCA
Sec. 406(b)
FORMS: 1669.03
OMB NO: 2070-0162 EXPIRATION DATE: 12/31/2005
RESPS:3,000 HOURS:413,577 COSTS(000):$0
TSCA Inventory Update Rule Amendment
FORMS: 1884.02
OMB NO: 2070-0164 EXPIRATION DATE: 09/30/2004
RESPS:31 HOURS:29,807 COSTS(000):$0
Data Acquisition for Anticipated Residue and Percent Crop Treated
FORMS: 1911.01
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
43 23,198,814 26,406,363 $9,236
Office of Research and Development
OMB NO: 2080-0005 EXPIRATION DATE: 02/28/2005
RESPS:5 HOURS:4,718 COSTS(000):$89
Application for Reference and Equivalent Method Determination
FORMS: 0559.07
OMB NO: 2080-0021 EXPIRATION DATE: 04/30/2003
RESPS:23,430 HOURS:241,619 COSTS(000):$0
Performance Evaluation Studies on Water and Wastewater
Laboratories
FORMS: 0234.07
OMB NO: 2080-0033 EXPIRATION DATE: 08/31/2004
RESPS:1,940 HOURS:164,900 COSTS(000):$0
Quality Assurance Specification and Requirements
FORMS: EPA-ICR-0866.06
OMB NO: 2080-0048 EXPIRATION DATE: 02/29/2004
RESPS:1,511 HOURS:1,620 COSTS(000):$0
Request for Information for Bioremediation Field Initiative
Database System
FORMS: 1672.03
OMB NO: 2080-0050 EXPIRATION DATE: 04/30/2003
RESPS:1,800 HOURS:12,240 COSTS(000):$0
Evaluation of the Burden of Waterborne Disease Within
Communities in the United States
FORMS: 1727.02
OMB NO: 2080-0058 EXPIRATION DATE: 10/31/2005
RESPS:30 HOURS:2,090 COSTS(000):$0
Personal Exposure of High-Risk Subpopulations to Particles
FORMS: 1887.02
OMB NO: 2080-0065 EXPIRATION DATE: 09/30/2003
RESPS:13,400 HOURS:5,145 COSTS(000):$0
Health Effects of Particulate Matter and Co-pollutant Exposures
Near the EI Paso/Juarez Border Crossings
FORMS: 1940.02
OMB NO: 2080-0067 EXPIRATION DATE: 08/31/2005
RESPS:600 HOURS:525 COSTS(000):$0
Reliability, Validity, and Variability in Behavioral
Determinants of Drinking Water Disinfection By-Product Exposure
FORMS: 2030.01
OMB NO: 2080-0068 EXPIRATION DATE: 08/31/2005
RESPS:10,980 HOURS:5,000 COSTS(000):$0
Natioanal Epidemiological and Environmental Assessment of
Recreational Water Study (N.E.E.A.R.)
FORMS: 2081.01
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
9 53,696 437,857 $89
Office of the Administrator
OMB NO: 2090-0014 EXPIRATION DATE: 04/30/2003
RESPS:13,100 HOURS:6,550 COSTS(000):$0
Pre-Award Compliance Review Report for All Applicants Requesting
Federal Financial Assistance
FORMS: 4700-4 0275.07
OMB NO: 2090-0019 EXPIRATION DATE: 04/30/2003
RESPS:68,740 HOURS:15,536 COSTS(000):$0
Voluntary Customer Service Satisfaction Surveys
FORMS: 1711.03
SUBAGENCY TOTALS
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
2 81,840 22,086 $0
AGENCY TOTALS:
ACTIVE ANNUAL ANNUAL ANNUAL
REPORTS RESPONSES HOURS COSTS($000)
363 68,445,779 137,756,150 $1,193,946
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